The URL can be used to link to this page

Home My WebLink About0289 CAMMETT ROAD - Health t�S 7 - LOCATION SEWAGE PERMIT NO. VILLAGE INSTA LL,ER'S NAME i ADDRESS B..a m,crm 0R OWN ER a DATE PERMIT ISSUED ,,, =ccf DATE COMPLIANCE ISSUED ; . _ ., i � ��, r�_ � <, F`�. �'-_ �� _ �( w '�� ----A �; No :?.l.L...... Fxs.. .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH Ce '`C� OF.......................... `' -... -Cam.........__............_. —AppIffaTion for Dis aoul Works Tnnitrnrtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal U System at: g p ..... _� ,� ................ .' - • --...-_................... ..........................�.. ..... L c lion- dr .............. r0 / ...r ,x ti.._.Y. .. ./,''o�..° ..�1.. ............. r o. a - ....._.. ------------- Installer Address / UType of Building Size Lot...... .....Sq. feet Dwelling—No. of Bedrooms................ -----------------Expansion Attic (1t + Garbage Grinder aOther—Type of Building _______Y/G1 � +wNo. of persons...................... Showers ( �) — Cafeteria ( ) dOther fixtures .•--••••••-----••••----•-----••--•--•--••---•••--•-••.--••-----•--•••-••••--••----•-•---••--•••••---•----•-••-•••-•-••-----•-...------•.............. Design Flow.._......._y�n...._.gallons per person per day. Total daily flow----------- ...................gallons. W - WSeptic Tank—Liquid capacit ...gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No_ _____________ ___ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.....IBQQ. . iameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.................. Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fr4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W --------------------------------•---•------•------------••-•---•--.....-•-------.....-----------••--......................................................... 0 Description of Soil....................................................................................................................................................................... W 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 TIT I.:; 5 of the State Sanitary Code—The undersigne�ea urther a rees not to place the system in operation until a Certificate of Compliance has been issue y the ed ............. ... .... .. .. -------------- ....... Application Approved By....... -- •. . ......• ................................................... ..._..----•- •- ......-- Date Application Disapproved t following reasons---------------••---•--------------------------•--------------------------------•-----------------------•--•••--- ---•-..........-•-•--•-------•------•---•--•-••....••-•------•-•-•-•-•------••----------•-•-•-----...............-•-•-------------••----------------••----------••--•.................................. Date PermitNo......................................................... Issued-....................................................... Date Now tf= - ....... THE COMMONWEALTH OF MASSACHUSETTS / BOARD OF EA�L—T—H .....OF................. �a �1. Appliratilan for Dtapasal Works Tonatrnrtion Urrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ff1 j . Location-Add res , or t No. ........................ ter r-• -1._.�r�j k f:... .............. ,:. %�:.... z: = ,� ' . y__-__-•-----__ O n j Ad" Installer / Address UType of Building(/ Size -------Sq. feet Dwelling—No. of Bedrooms___..._.ci�...... .................Expansion Attic ( ) Garbage Grinder `LI Other—T e of Building 'l" a Other—Type g _______________�__: :�:,No, of persons____:u_______.._..__._.__ Showers (� ) — Cafeteria ( ) Otherfixtures ..--"-"-.-.--._.------"-------"--..................................................................................................................... Desi n Flow...........W g :._ll_r.........gallons per person per day. Total daily flow______.___:=_.� ....................gallons. 04 W Septic Tank—Liquid'capacit}y,:_ ?____gallons Length................ Width................ Diameter................ Depth......:______.__. x Disposal Trench—No __________�__f_ _____ Width.................... Total Length.................... Total leaching area____.__________....sq. ft. Seepage Pit No..___<<;� ___:F Diameter____________________ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (` ) Dosing tank ( ) Percolation Test Results Performed by........................................................:................. Date........................................ Test Pit No. 1................mmutes per inch Depth of Test fit: 4" °"'Depth to ground water........................ (i Test Pit No. 2________________minutes per inch Depth ofst�P _�.___.Depth to ground water........................ Q' ....................................................................... D Description of Soil -tw --------------------•--"-"--------•-•------------- "--------.....----•..; UNature of Repairs or Alterations—Answer when applicable------------------------------------------....................................................... Agreement: k 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 boardgf•`heal�t�i. f � / Wined - f«. / ty Application A roved B 5�` �' _______.... r. ..._----- ? -- PP PP Y . = - --------•---Date Application Disapproved�K�te following reasons________________________________________________ ._..._.._._.. .......................................................•-----•--••---•-•-----------•••-••-----.._....__...__....._....---•-------•---------•-------•--------------------•-•-----------------•---•-._..... Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....OF.......... .:... ... ...:....................................................... Tnrtifiratle of fP ompliatta _ TICS IS TO CERTIFY, T t the Individual Sewage Disposal System constructed (Repaired ( ) by. a Installer at__ • ---•--------------------------•--•----------------------"------.-_.-"---------•----•-----•------------"------"-----------.....-------•-•-----•---•-•---------•--- has been installed in accordance with the provisions of TI"'LE r of The State Sanitary Code as described in the application for Disposal Works Construction Permit No. .... e ............... dated----------...................................... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................I..._'..../._I'...�-5................................. Inspector---•-- .......--------- THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH No. ...................... FE .a. .. Dispog al Works k"nnstrnrtuan rrmit Permission is hereby grante ......... �� ---•----------"-----"---"-"•".............••..........----•-----••. to Construct ) or.�2epai vidual Sewage Disposal System atNo.-C....... -�'- --------- -----=-........................................--""--"-------------- Street ,r as shown on the application for Dispo al Works Construction Permit N _ ______________ Dated................ r Board of Health DATE = _._�-�_......--••"--- FORM 1255 A. M. SULKIN, INC., BOSTON y . I' V-;a GAQ�A,r,E Gwr,11�E2. p A,%LY( PLOW _ I I O x 3 = 5EPT1G -rA►JK u5c• 1 o0o GAL. A, - 'b 0 . Di,5Po5AL PIT v5E IvoO GAL. 5%DCWALL AV-EA. = I505.r ' I BOTTOM AcLEA- , Jro s.�._ K) G ko'o Q 5o S.F x I• o 5p Pp -ToTA I- rrcSIGN -raTAL: DA►L\( VL-C>W a PE2C.OLATIo14 PATE : I"IN 2MIN oP-LE55, Ns.TA-v r� Of �y Q ��0• Pt,q Sypy p DAVID WILLIAM TtiULIN 17 iI �• a v No.292Z6 n N Y E y ,c �E G(Vl��v4 1!� ,p No' 19334 Qpf G/SIT � I SUP, WOLF G 1000 SlJ� (J�L 0IST. INV cA�.' IW b . �iiG IOvO INS 13UX EPr too-G TANK � 4F j�gSs� G LEaGu , 10 r Pf ER y� Pl-r INV. INV. SULLIVAPd w l T u I r�•2 IOC •4 No. 29733 F•� I'�3�h�I/2- A�C�,��IS7:"QUO �L.�. VJA SK 6 D �`.FSS�QN • �,� 6Tv N E ., ..�✓ � t0 �•2- 6 Q �c N GERTIFIGD PLOT PL.A1.1 � p P1ZoFll.� L0.4A"tloN •Z Wo 5GA.Lti= c _ ( Itr�O� �ATrc C9 ,� - Pj�... I. ,v S ALE, � !JD lrUtk� N GE-- „ I THAT THEou►xv,��i''4Ar.i SNOkYN Il NER6ot.1 COMP L`(5 YJITN THE S I oELIt�1 �j Auo 5G6TeAC- 26R Ia.EMEWr> oF -t1-IE- (� -Tr A Tl--F3 LEA tJ-D I S IJ c� i� 1 C-A�J �OC�IE- �Cn� ��•C�C,."�� I LOGf,.TED WITNIIJ TNt~ GLOdD PLd.IN BAXTEiZe r�YE INC• R.EG 1 S"r 1✓Q6�'1�110 5 u My E`�oeS "T%At!! PL&N I t:1 N1Orr C3n5r D 0►d A O'57G9-VILLE- - MASS 11JSTR•UMENT SVQv>!`( Er`T'NE o�=�.SE�'S Suou� I( ti1oT t3E VSEDTb pETE�Z!^11.1E L.oT -l►-IE�J APPLICA►JTo�EeT iIAY� ►�