HomeMy WebLinkAbout0022 TRANQUILITY LANE - Health 22 Tranquility Lane
r
a O
s e 150
tervill A= 121 —
a
° o "
e
0
r [��
e
°
" yg
°
0
"
¢ s �
Y°
n
71
r
:
` ° A
ry
°
`
c " �
° o
ry
V
0
V ,b
- � a ° - aN ° u m J' .� „ k°., L c �. b• " V` "� n .�� .6�I�� '�piVF
„ ° u
r
°
° ° +o ° oo .of
s
;� . , a, � ,�,.,� °• �,"w h y d. "e, - ° ., e� .^, yam � ..°,pa '�, ".,- � "' �: � e°�NA'A �
plc. aA k gip• ..p ° .O , �
a f/ M ?
wit,qq
°� N i dY ° 0 �
y. h
e� "
Ac
t: y
e
e a
� „`� s" � .' as y - •" e 8 �A °� °" h a'��-e •a,. � T � F���ye, '°��'n A „ '•'dory n�,
a n
�6
°Q
e
,
,
°
Alt
�r
�
�
R�
e,.
e
M
°
° e
"
T V
� a
"
o b
R r�
P o
^
:
° s
W" °
°
° e �
1
°
°
^ v
p n
o °
LOC TION SEWAGE PERMIT NO.
a -i�s-a
VILLAGGEE
A,ae t
INST LE S �N , !E ADDRESS
BUILDER OR
N
DATE PERMIJ IS UED Cf
DATE COMPLIANCE ISSUED.`
--
�.
++` _ ��
'��'� ,
,` � /.��®
�.
� �g> /
� - � - /
... ff c
1
� - � � � i
, ,
�,�
;J
No..0 2�1,�' 3 0
THE COMMONWEALTH OF MASSACHUSETTS
BOARD QF HEALTH
Application is hereby made for a Permit to Construct ( ) orRepair ( ) an Individual Sewage Disposal
System at:
locati-t
Installer Address
Type of Building Size Lot.....3A.).Sj�.Ck..Sq. feet'
Other fixtures
Percolation Test Results Performed by----------- ....Alft....................... Date-----3./I-Af--_-----------
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued�b Wthe.,Za ;ah.
Date
Date
'------'—'-----
»"te
Permit No —
Date
THE COMMONWEALTH OF MASSACHUSETTS
� BOARD OF" `�HEAL.TH
6- 11.1.............OF.......... ,E"A1.—4S.'�i9glt_--------.....----........------.
Appliratiun for :Riipagal 10orko Tianutrnrtinn rumit
Application is hereby made fora Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
------------
--------------------
LocatiAn-Address or Lot N .
------- '� �1. - t ----------------ffCoR-4a---1.83---------------
01111
wner Addr s
w -- -��------ 111,. --------------------------------- ............ ----------------------------
Installer Address
d Type of Building Size Lot----------------------------Sq. feet
U Dwelling No. of Bedrooms _______________ _Expansion Attic Garbage Grinder
a g—
aOther—Type of Building tr No. of persons-_-----:Z•................ Showers ( — Cafeteria
Otherfixtures ......................................................-----------------------------------------•--•--- ---------------------------
W Design Flow................................... gallons per person per day. Total daily flow....... _1 __-________-.__- --------
WSeptic Tank—Liquid capacity _gallons Length................ Width.--__-_-_---__ Diameter................ Depth----------------
x Disposal Trench—No_____________________ Width--------_----------- Total Length-____________—__--Total leaching area--------------------sq.,ft.
Seepage Pit No._1�� a Diameter___ . !_______- Depth below inlet.....� ---------- Total leaching area-___--__-_____ _sq. ft.
Z Other Distribution box ) Dosing tank ( )
'"' Percolation Test Results Performed by.____.._ .- k 4.vrrc e___ _______________________ Date.__"__ '_ . _l___-__________--.-
M Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water----__--_______-___-----
f: Test Pit No. 2......_.........minutes per inch Depth of Test Pit.................... Depth to ground water---_....................
t�
f•. . --------------------------------O Description of Soil......................................................................--------------------------------------------------------------------------------------------------
x ..•
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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued b the oa d f h
Sign a
Date
Application Approved By AT --
Application Disapproved for the following reasons___________________________________________________________________________ Gib
---------------------•-•-------------------------------------•---•-------------------•----•-•-------------=----------==--•---•--••----•---•--------------------------------------------------.......
Date
ram= .,
_ Permit No..................... ..................... == = Issued - ------------------------------
Date
THE COMMONWEALTH OF MASSACHUSETTS
*. BOARD OF HEALTH
...........1.. .. ...........OF...... .64.S,.rM..C......................................
Tutif utt#r of Tompliatirr
THIS IS TO CERTIFY, That the I dividual Sewage Disposal System constructed ( ) or Repaired ( )
by-------------------- -k-Rk-K---------�'4A.&Z.........---------------------.....-----------------------------------------------------
Installer
atGle _ �. �rtt- "�-- - �1� - B �A: :-------•--•----------------••---------•-
has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the
application for Disposal Works Construction Permit NQ _ ,,____________________ dated........................_.......................
THE ISSUANCE OF THIS CERTIFICATE SHAi NOT BE CONSTRUE® AS A GUARANTEE THAT TIME
SYSTEM WILL FUNCTION-SATISFACTORY.
N DATE.............................��` �................. Inspector - G
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...... ..........OF.. -44-4- AA1. --.-_.----•-----•---------••----------
. ?-------• F d__0------------
Permission is hereby granted------.. __::1_640-......t"'t kA.4"/;h, ------------------- --------------------------------------------•----------------
to Construct ° ) or Repair ) ,/�an Individual Sewage Disposal System
at No.......A0,..�--...'�� r ��+���2°�t��------ .1 w ----- /_a
Street
as shown on the application for Disposal Works Construction Permit No--------------------- Dated---------------------------_..............
.�" -- -----------------------------------
-......... Health
.72
DATE.................... ...................................-��
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
f D�S►�••t� C�4TL�
C,,,t►1�t_E FILM 1 t,.d - �� �E�OArI -
1+VtTAI
5 ''fzG TAt.►K • 3p X2o0o� Q(� t ► M 3
USE
AMMA
��. 2 A�,l oe L.E�,+ S
100
i#9Cp �ti t'rd
t
G= 6lop
7 -••��
PE J !'0 p �N1[• `�l•o
9�,G �,cYl'IG
2 Sot. TALJK
NCO pt T
S 4D , WtTIA
3-$la•Q'Js � '
WASr4t� .
tTa U 6► i
Qp.O
Cla�eT1Ft�a R•oT' Pt_a�.,
l00 �..�'`�= Qlo
/o lUaret
t Ccr-TI FY TKAT rt-4&— 67 S>.uy L 2
r^1E2Eoat - Go�.cP�-`YS W.�T�1 'Riff. =st��-%"Is& c- a
AWD S T8.4G�C �� 4-•A�t�1�.MG�JT$ OF TWft
TbuVtil OF �tQ�'�vr/1 f.J.' � 4-���� L�CJ�,�`� F �-•l1� L.�J..t J
DD►TE. f �.-'l ...' 8 A YC T E iL 144 Es %4-4C..
7-s;4.tSTG. Mato l4ub 4;0ZVlDPU , 3
Tµ 4 PL&W 14 UOT BASED OU AU 64TCOME"T OS•TEaXV%,- t . A�tA�. •
SueV�'! T"6 oGFSFaT; 'SI WLVO UOT• $6 USED ApPI.IGAatT �- �}
To -Vs:TeCM'WlL ity7 UWS*- i