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Home My WebLink About0040 APPALOOSA WAY - Health 40 Appaloosa Way A = 174 -001 -X28 Marstons Mills - - - - - �- �17�A PP,44"e4TOW ARNSTABLE LOCATION L-C i * Z GI0661 W<.�. SEWAGE # VILLAGE u �'�°'�`'+ 'ASS SSOR'S AP & LOT INSTALLER'S NAME.& PHONE NO. �` V 6 i 5c AI 7 )I- (Cy o SEPTIC.TANK CAPACITY LEACHING FACILITY:(type) L-eAC�, Pi'i (size) t,000 ry a tj m"J, NO. OF BEDROOMS 3 PRIVATE WELL O PUBLIC WATE BUILDER OR OWNER �7Ay5�� ,.�} Lp• 7171- 0 9y DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED_, E- = �1 VARIANCE GRANTED: Yes No f1�3 C4 S9 � Lo-� 12 f No'"� Fics.......1 to.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..TO.Wt. ..........OF............ �... ,................... > 7�3G off', pupation for Ili,4pootti ork's Tons trurtion Frrmi# Application is hereby made for a Permit to Construct O l or Repair ( ) an Individual Sewage Disposal S tem at: `/v ) p �aR I . - ........................... - //��Location-Ad ss or t No I ................_...._...........t4„i. - +�..! ! c1. .c.. - --..... �J.. . Q4t-?c�v�.:�:!:�......_._..... wner� A!5re�s r ................................... ..1/c.S�o G�...--• fe u cc� ................. ._.:..... ........ Installer A Type of Building Size Lot..l s8.S -.Sq. feet --- -.. . Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type T e of Building No. of persons............................ Showers — a YP g ---------------•--...---••-• P ( ) Cafeteria ( ) 04 Other fix ures ..................................... Design Flow......................... . 7 ...-..gallons per per day. Total da'y flow...........2..��...................g-410 . WSeptic Tank—Liquid capacit*Y/Mbl U..gallons Length&.-lr_----. Width:...4-Va-... Diameter................ Depth..__.. ... x Disposal Trench—No..................... Width.................... Total Length............... Total leaching area....................sq. ft. 3 Seepage Pit No......../........... Diameter......«... Depth below inlet.._-�:. ....... Total leaching area_Z`f ....sq. ft. Z Other Distribution box (� Dosing tank `" Percolation Test Resus Performed by.....G. 2-...�oUT...........r�................... Date.... �,3�..B-.7...... Test Pit No. 1........?r7....minutes per inch Depth of Test Pit.../Bj�....... Depth to ground wate ..AJ.v .. f3. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ................................................................................... ODescription of Soil.... •••.......•--� ......-•-••---•-•--•---•-••••••--•••-•..............••••--••----•--•---••--•-••---------•••..._._.........------......................•---- V 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 kITLZ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b n issued y the of Health: �/ .. Date Application Approved By.......... ="-/-? ' Date Application Disapproved for the following reasons:..............•-----....--------•--------.._.........---------.......--•-------........... -••-••••••-•..._.. .... ---------- - Date PermitNo..... ... Issued....•..............................•••-•-.............. Date r$ / - THE COMMONWEALTH `OF MASSACHUS'ETTS ` BOARD OF HEALTH , 1 Q.4..........OF........... M1 � 3 G Cl Appliration for Dippuuttl Work, Tonutrurtion rrmit Application is hereby made for a Permit, to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: g P ..... •• _---. .... y Location-Address •• -•• -»»•»• nn + /' or Lot No. .._.. - - - -/ I GG I f r c( rt_ 1 L t :.1. i..C. t„e. 4P ? � C1 I:L.A_Yc� �r ... Owner Ad re°ss a •-•-.....--•........................1....... .....�CL....r..... ....... r......................--......�.. t{.��................................. Installer Addresst Type of Building Size Lot_.r........... e...Z:_..Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixkures .................................... i W Design Flow............................................gallons per,person per day. Total daily flow............ 3.--.--..... ............gallons. WSeptic Tank—Liquid capacity.RA).gallons Len-gth.f._G__.._. Width:_. Diameter:............... Depth..>...:fL. x Disposal Trench—No..................... Width.................... Total Length..............._... Total leaching area....................sq. ft. 3 Seepage Pit No..................... Diameter...--1�.... Depth below,inlet... :.:5...•... Total leaching area_� ..�E,...sq. ft. z Other Distribution box (,\e-) Dosing tank ( ) Percolation Test Results Performed by.....C...�.....K-.. �.. ...•............................ Date....v jv .................... e! ....._... Test'Pit No. 1... ....minutes per inch Depth of Test Pit....&........ Depth to ground water. ...U!v�.._.. LL, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ - -- -- -•- O Description of Soil........F. '_�.1. - 1.15 ••-••-•••-•...................••-•--•••-•-•...------••- V ...............•--..._...........--•••-............••-••---•-•-•---•••-----....._......................---•-•-•-••••-••--........----•------••--•...........---•--•....... . ...............----...... 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 TITIL 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 s% . ............................ ----•------�� ..-. � -- .� Date Application Disapproved for the following reasons-------------------------------------------------------------------•---------......-•-•••--••••.............».. ....................•-•...-•-...••--.................----........------------...................----............--•-•------------•---------------------•-----=------------------...------•-----........» ` / 4: Date ....» Permit .No........... -- ------•--.- --- `'Issued.............................--•----•-^»» - Date .... ........a....r.roms..o`.... -. --p.....,.-....-,..._..v9.e- .-:.-..:.,..de..e_,..----..-------- y_------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............................> ............of..............a tU.�...... !'.��-�'-----....... (Irrtif iratr of Tomphatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (/,,) or Repaired ( ) by. 1 !�.. ? ..........--••---•-----•--•....................•--------------.......---•-----•-------•--------•-- ............................................... �/ Installer /,, — ,67 at •....-- �..•- •�••-- .. . ------ !f?+7 aSL.... !k�s-jj�.... ----...�....--. ..................... �---...-•`-••--•./--------••---......-•-------- has been installed in accor ance with the provisions�f TIT .� j�o The Sta�Sanitary Code as described in the application for Disposal Works Construction Permit No_- -•_. dated--.......---.................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NO jT BE CON,S'l;RUED„AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFfkCTORY. r,,'` lf DATE............. ..................... ...................... inspect or.^..... ..._... �. .......... ..................... .._............_._ w -A^^FT^-'^ - ..-._m.,M..b^-.m+«T`--^° m - e.-wT- THECOMMONWEALTHOF MASSACHUSETTS ....-m..m ro '-..__.-...-,._..--.. ___M•'__c� BOARD OF HEALTH c No... �'/• OF .. FzE.....:/ ... .... Disposal,,,�vrkis ITonutrurtion Vrrutit Permissionis hereby granted.. .. ......................................................................................•-•-••-•-------................-•.._..-- to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at No..... G a `� W-014� A lv I kp► /,0 4-......am' -•--••......•.--•••...........................................r-•-.-------.------------- fLCI �---•-------------------•-•-•------.._........----•---.. r Street as shown on the application for Disposal Works Construction Permit No..;: �+K ated.......................................... .a ............................................» p _ oard of Health DATE.............. _ �..". .................•..........» V - i I f i I - 1 I j I 4- ?-- -- r- --- 17 47 ------------ 1 I j T - _ - I -- __ I 77 It I 44 T I I - ---- I I I ' v : 1 ' , 1 y -1 4 P4ac.E L 1 x z`Z WITr�1c55 � D� n!tifcn•!C� off_ 1 ,ram 2a1E' m'^/nc— trace 14p �o _ - I � ..�) 50 arxi VY�,t4Yar11�, C�r� W 130 1.1 I l F� E E A.�l.&I LA[�1.�, +�atC � 2 M u G A Iti► PIT_' 1'rG�= I T t l►1t.E� P 7rl4e2,0,II CJT� P �F 1�'�'° ` . 1 5. Pi Pr— J o oj�� CiE Nl.a M G Tc> P-£ 14iZ'N Mom. ENS r-'+.t��Fc�to L GoC'E `rT 1 i � '�... (. 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