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Home My WebLink About0314 CAMMETT ROAD - Health �_ C LOCATION SEWAGE PERMIT NO. VILLAGE INST LLER'S NAME A - ADDRESS BUIlDER OR OWNER D A T E PERMIT ISSUED DATE COMPLIANCE ISSUED, Z,�� yd w t� Zra v 1 7 No........l` .' .�r- F� ............_. THE COMMONWEALTH OF MASSACHUSETTS e�•� I BOAR® OF HEALTH I-.uL.f W..................OF......je%en..��a.le.------------------................._........ 31� Appliration for Roposal Works Tonstrurthitt ramit =� y Application is hereby made for a Permit to Construct ( &I"or Repair ( ) an Individual Sewage Disposal System at: --- .QtZ�eZ,1...��----------------'-----....-••-•-...........•----_... ----------------Z�2..----...-----------------.........---..........----------•---....---- ( t L cation-Address �T t No. .lU .. . .._...-^. ...CCY/!1'lf?1L'. A ................................................ ner ress a ---- -"................. ems.._. .�.__,1 . Installer Address Type of Building Size Lot............................Sq. feet ,., Dwelling—No. of Bedrooms......... Expansion Attic (tom' Garbage Grinder ( ) a Other—T e q yp of Buildin g ____105-_•-•-----___ No. of persons.... Showers (-I — Cafeteria ( ) Q Other fixtures ----------------•-•---••......•• . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity/_Ol_:�'�gallons Length................ Width................ Diameter................ Depth..._............ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter..................... Depth below inlet.__..___:__........ Total leachingarea..................sq. ft. Z Z Other Distribution box ( ) Dosing tank ( ) G1 7 �j' - ~' Percolation Test Results Performed by.......................................................................... Date....................................... aTest Pit No. 1.....�....minutes per inch. Depth of Test Pit.................... Depth to ground water------------------------ (.T4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 ........• ------------ .....................?_..... ................................. •• .... .. .................... O Description of Soil•. ., .nx....._ '___ . � "�. "'7__ /� '--•'-'-- -•-'-'-- . ---------------------- _--- z------------------- 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 TI'L 1Z 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issu d e d he. Signe�-• . ...................... .....K..�7-.22 / _ Application Approved BY C'"'" /r�..-��/_crl l_�..��--------- ...............................-�------ �) yL ,, Date Application Disapproved for the following reasons:__..n...._.-f-�-4.....�...__.� _.._!_�x............................................._ Date Permit No. _ Issued ¢ �.....---�--� --V............ Date AIX 40 Fim No----------------------- 14r' 1111�6............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH own OF........... ................................... --- ---- ----------------- Allpfiration for Elispatial Vvrko Tom3undion Frrutit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: 7 .................................................... .................................................... --------------------------------- ocatVn-Address ....................................... ---------------------------------------------- ---------- ------------ .... Owner Acidre .................................................. .................................................................................................. ............. Installer Address Type of Building Size Lot__________________________Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic L'y Garbage Grinder ( ) Other—Type of Building ----- No. of persons.........2' _------------ Showers Cafeteria ( ) PL4 /�_� Otherfixtures -------_-- ----------------------------------------------------------------------------------------------------------------------------- Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W Septic Tank—Liquid capacity-/P&Z-Jallons Length___--__--:.'__. Width................ Diameter..._............ Depth....__.._...__.. Disposal Trench—No.-------_---------- Width.................... Total Length.................... Total leaching area....................sq. ft. • Seepage Pit No..................... Diameter....._....._.__._... Depth below',a*nlet ..... Total leaching-area..................sq. ft. Z Other Distribution box Dosing tank Percolation Test Results Performed by.......................................................................... Date-----------------------------------_.... Test Pit No. I_,;.._..minutes per inch Depth of Test Pit.................... Depth,to ground water_.__..___..__.__....._.. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------_-_-----_------ ...................... .......................................... 0 A/ ..........Description of Soil_ 0 - ....................... ..Z.Z.4----- .................................................................. U ................. ......................................................................................... ......................................................................................... 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 TITLE 5 of the State Sanitary Code— The undersigned her rees not to place the system in operation until a Certificate of Compliance has been is e y t e f 11 e Signed ---------- ---- --- --------------- -- ------------------------------- ------ Date Application Approved By...... ......... . .. ...7.7...... Date Application Disapproved for the following reasons:................................ .......................................................................... ....................................................................................................................................................................................................... Date Permit No................ .............. .............................. IssuedL....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF 6LEALTH ..........7. OF............... ...... ....................... . ... ............ Tutifiratr of (11intiffiattirr THIS IS TO CEf TIFY, That the Individual Sewage Disposal System constructed '04) or Repaired by ................. ............. .......................................................................................... ............................... Installer ' ---------------------- at ... ........A4-io...................................................................................................................................................•................has been instilled in accordance with the provisions of T 5) of.,Tie State Sanitary Code as described in the 'application for Disposal Works Construction Permit Not... ................ dated-f-744....7..7............... THE-4SSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS AGUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. I)ATE................................................................................ Inspector..............................................................I...................... THE COMMONWEALTH OF MASSAC KUSETTS V BOARD OF HEALTH ............ ... . ......OF.............. ....... . ...................................... FEE... Disposal Workp Tomitrurtion ";Irrmit Permission is hereby granted-..., ................0 ..................................................................................................... to Construct *_4 Repair k� an Individ_qA ewa pdsal System No.... t AWZ�at ... ... / ........ ................................................................................... Street f a shown on the application for Disposal Works Construction Per o....... - ; '7 7 s .... .... ated----- --- ............................ n........ ... ..... .. ..................... Board of Health DATE................ ..................... ..................................... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS i' { �r� Jt�is ct/vttb PM `� d 4S So,- + —----- / fyj TYP1C&L SYSTEM MOFIL-e V. n :..•cs�\1CY'fA6,�C (-♦ ' 1' IJfl 1 I_CF r�c�k- j l�33, � ^` r __i---_� —♦ . • ^I, • . • 1 , � _Q 4 V S T. CON Ci t'E k tj f�w i C-. .� Oq .. • ► • e' c n n n ! .y i 21`T G $" tf- .a�- ♦ d o o . ��D� �fj A IEYEt 5TA61_E SASE. • w , • n I _ ,, tt SE PTI C. TAII�C. • n ' --1-0 r)E IN3 AL.LZD ON A , r,WI�SF'FUQEhS�"4iiE- ALL - 't .'s`r R I Gk ` M�R t .i7_ C:7UR.rd�'S A'S / I ' 1 A;26VNV; FREE DE 10N - , MNFS , ..� -- - rz c K• t cC.A1 t !c t+ F - 2�UI IL L1•` TJ.) E5Vj I" 6^VF :-. 7b r�D� t- �11 p Di15't- - \ —trr(. I- /ilA�1A1t�— 1LYe�- -� - '/•4�Ir 1t� /►' W.ASI4i-11 CEOSHE.D faCNING 1T . �Sl'ON E �tLl APD0NU T-L'EE nf- ") kS - t_ 'li=.E_ lIJ f.S ,9WG NeXT tRl LAr f \ w � a �9 -------- ----- h- 4- : - — — � F- O p��Ytov� I MA+If I;V.11 r W N F' - A 11 ,I - -- - ! \94 @ '` <<'�A I_ ci-+c rr, a , 1, f1 �--•j r c , 1 ray - �. !• � � 4F t' � � �( i o 1 � - RI LEA.C1A1'hIG Di s-Fcnau v a Flo `�cAEF DATA !LL}>V rt•:"+ �,l��t��!°r',: OY ,!. _ i gD, O f- - -------- �'" F 'SSE U CT_GCJ 1Vt� }' A t t l 1�CS f1,--r T6 t A L. DA I L r rF-t1-.•F- N`i'- 460 G'A L:!5 5 r t0-ri c It A q v �- Z, �c( u WIE_E - �aAIXG �jD• Crrt. 1NC;I.b► _U WI1 f M !�rfSQ,F'r�GRL ,w kTY I. AL{- �Y'�?rM COMPt7K�1'Cl5 -314AL - L9E ►WTA� L.EU if( t NOT-F., ACjfZ5tZUA9CE WITH A121% Ai Cf' -n4E. StAir- -!5ANcY.,'\ �isV. __—__r XCA� ; f _ rC% BEY• 1?D.p pp 1f'W k'. A� -DATi`D &-k-; 16,I'lC4, AND ANY I-OCAL- VJ-11.ES A PrW CA rl,ti�- I P � A \ - Fr-Q �IR.I`!D Tc REMOVE. ALL I-.DAM LAY Clat\t'C/llKIIVICc z atY�,ANar 'W 'MF Pµu Mcl'T Pr- AFrW-vrU 13Y 714E MA-�MAr ?�QEATH t rtf:_AC.F.. '41�t) MA` 1-�tAL. fOA e7 f HEAL_` 14 - t WDMP,tGTES: u�,ISZ�E GZAV�: Nt(��t-'' , Y w rI F H �� sr�c�oN Is PPl DID Ta^ ►,(,oll F Y oACLI OF- 7 i 634� �AL=I�� o� �Nb EC. - 4.jClrHnA-"IrN f_ CV, MU_`•T 8f. Gtjl=LiCYG WWN VGU Y MA g;STo �5 1 L L 5 A, 15 S • CN06E1� W111-400T` OW t1EID , - - v i. OA c: ('F t115At-TH IN3pF1".tt�N F D. Wfjt'4 Gr.CAVAT.:_C. _Legen d 0 S�Ept� i C .S _ �0, REV DATE DESCRIPTION IoP, � Pips. iNyg X. f!4-fY- (2 A5F-L• nrtEi� t t 1T . Sewage Disposal System t h �� E..�.Y. C' � 118•gs''rl F O R + -- - OSE Pti t IC .S, III i;�sT,"� uT►�u .-., ,� ��, CW MATT 20AD, 1 �lrE� K-1: Ef2�UCE t + . A M f`r�, -Z L:a� l a "' Y � Wa I f�e r MA 5 T o JM I L L AAA S. 4 1, �, f E Yor�ng3 i, o.8l� , Designer: J pU!vCi Dale: N�'�/'ic DRAWING NO: �P..,��, .o G!S�Ep• a + T� FLAK E {�(�1Yi to C- h 'Qa� Drawn: \k f Y Scale: A5 4tiow N COfG Z2�3 I�GE: �sS' T h^ pop, F�ss.,r•t+?a' .Checked:^UI�,7y —