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Home My WebLink About0240 TANGLEWOOD DRIVE - Health LO CATION SEWAGE PERMIT NO. VILLAGE IN.STA LLER'S NAME & ADDRESS _ A1C B U I'L D E R OR OWNER T "t, DATE I PERMIT ISSUED . � 2-7 DATE C.O-MPLIANCE ISSUED /3 �� . .� ��v, r _ _ '�� No.(F2 THE COMMONWEALTH OF MASSACHUSETTS BOAR® HEALTH :.... Appliratiun for Mipasal Workii Tonutrnrtiun Famit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: o �� 1� drieso ,PQly<_ / G T / 3 a sT�g y/Le --... .... ...... ------•-_•-------------------••--•-•..........._.._.... .......--------------T---------...-- - ....... - • ....... ocation A ress r Lot o.. _.. - -•--••-•••• ---------••--••----•----•--•- ....... ••-• -•---.._...... -........._..... Owner _ Address - -•••-• .mo o i s'-- �.� �_s-��.�s.. f ... Installer Address dType of Building Size Lot___ _.... ..3.......Sq. feet U Dwelling—No. of Bedrooms--------- ................................Expansion Attic ( ) Garbage Grinder pa•, Other—°Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures _________________________________ _ W Design Flow........ _ __........................gallons per person per day. Total daily flow..... __ U_______________._______.gallons. WSeptic Tank L Liquid capacity e64 gallons Length................ Width................ Diameter________________ Depth................ x Disposal Trench—No_ _____________ ____ Width.... .---------- Total Length...... ._ Total leaching area....................sq. ft. Seepage Pit -No....../------------ Depth below inlet.....6t.......... Total leaching area_.;.2-.:v_ ... ft. Z Other Distribution box ( ) Dosing�ta�nk ( ) 06- /,� 77 FC47 0-4Percolation Test Resu s Performed by..__1;U ___ p� ___ 6to�_ _ Date__:- a Test Pit No. 1 _._: _.-----minutes per inch Depth of Test Pit______________ De th to ground water....................... P (1 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of Soil......S7W... ----------------•------------------•--- ... •••--...••••------------------------------------------•--------------------------------------------------------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 iITi U 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee. •ssu d by t board of health. 1614 S• Ig - -- -- --- .................... ---------•-•-••-•-------•--••••--••-- ....__...---._.._......---•---- Date Application Approved By. = =•-- A -' � ----••- Date Application Disapproved for the following reasons:.............................................••-•••-•--•••----•-----------•••••---•---------•---•••••---•••••-- .................•--...--•--•---------•--•-------••----------...-•---....----•------------••--------------•-••-••-•-•••-•--•-••••---.__------------------------•---------------------------------._...-- ��/J Date PermitNo.-•-••---•---•-•-••--•-•••-••-••••....................... Issued-••F- ..(3_IR............................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARDOF -IEALTI=� . pphration for MoVatial Works Tonstrur#inn Vamit Application is hereby made,*for a Permit to Construct .( ) or Repair ( ) an Individual Sewage Disposal System at" ocation-A ress r t Lo 0 �/ e// Owner f r Address ..... . Installer Address Type of Building Size Lot---/._.`" ..V ..Sq. feet �.. Dwelling— No. of Bedrooms....... ............................Expansion Attic ( }, Garbage Grinder (/_�o p.l Other=Type of Building ........................... No. ^:of persons............................ Showers ( ) — Cafeteria ( ) Pa Other fixtures •-------------- ------------------------ / --------- -------------------------------------------------------- --- ..........•-•-••-•....... W Design Flow...... ...............a,40.......__gal lons per person per day. Total daily flow..... .........................gallons. 1:4 Septic Tank Z-Liquid capacit,� 9..gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No. .................... Width...�T' Total Length ..... ........ Total leaching area....................sq. ft. Seepage Pit No_____ ___________ Diameter .. . Via._. De th:`-below inlet.__. . Total leachingarea.,2AL_ s ft. /� P ,,tt y�," q Z Other Distribution box ( ) Dosing tank ( ) Df�, /�' `I� tvc �E� Percolation Test Res is Performed by._::u6t-- ... ._ _d2t . Date..- 14 Test Pit No. JZaL.......minutes per inch ,Depth of Test Pit...............:.... Depth to ground water........................ Test Pit No. 2................minutes per inch D`. pth of Test. Pit........:::......... Depth to ground water.-,..................... _.. ...,, w ........ -r x _ � - D Description of Soil---- 60V..............(7... .2 `� h x 1 :........................................... ..........................................b.........................__..........---............... ...._.........................i.......................... W ...........................•---.....__...-------•--.........----•-...._..._..__.....................---......------------.._...7---._............__..................................................... 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,pf TITLE 5 of the.State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b`e-ej ssu d by,te;board of health. F Sig i"-'.. ....... r --- Date A lication Approved B �-.. .e ?" e!.:...... l� Date _ Application Disapproved for the following reasons:........................................................................................................... :... ------------- -------------------------------------------------------------- g Permit No.... .........•----•.................•...... Issued-... - Date...._ Date ji Tl .E-.COMMONWEALTH OF MASSACHUSETTS BOARD O HEALT .......s..... fifi ' ....:...:a.OF......... : . ................... } Tnr#ifiratr of Tautplinnrr `T IS IS TO CE .�FY, That.the Individual Sewage Disposal System constructed ( or Repaired ( ) by.. .............•--••--- .......- at------L. Kk ------X-44, �XI st AeA J4' - y:!t has been iris wed in accordance with the provisions of T ` of he State Sanitary Code as described in the ` application for Dlsp sal Works Construction Permit No.7 ....... . ................. dated_ 1w 7:r_ ............... THE ISSUANCE"b51 kT, IS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY..,:`," DATE----•-i . ..................................... ........... Inspecto'f................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEA TH ...............O F.... .. t ! ............................. .s No....... ,f.:......... FEE... .�................ Mops Vorkii nstrgdion firrmit Permission i�hereby granted--~ �_... .. t "' ---------------•-----------------......------------...............---•-----•-•... to Consfrugff ( ) orf e�pair an Indiv swag sposal ystem at No..r!&a. L------------- tt'-- y ...... . ---- .......................... OrStreet as shown on the application for Disposal Works Construction P it Dated..`_A..7:'._7 .`.......... > - --...--•-------•..............._ Board of H It DATE------ .._.. ...--------"------------------•----.....-------•----------.:•••-- ; FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS; - i - A� j3i THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I A , �- m / LI DATA - s 1_1--nn T AartK = 330,r iSO °xo • 4G}�j 6.P.D: �,�/W C+G.� �/t/C Ip t/�/1/� use t ooC� 6A L. t�,U 5F" � �•� 4 x lS G.P.L . / TOTbL •'C7ESI6Q = 4ZS Ps7uP1 t Sot "c,4 t u-( r L.O W = 330 �:t?D. � '0 # L :-.ft'rDl.laTt04,.1 �'I�TE �I,i�.1 Z�t�#J• � �.�.5�. \ � tl�`�' srhr.#,,t��. �' +�., Ioej •�r- T �. Tor 17W AAA G SPA'- I ooc> Imo/ ;a 4 6AL °ilo.$. ;-�K to' •.. lWV. Go 4 LAN co 'Pt T '. 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