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Home My WebLink About0057 CARLISLE DRIVE - Health (2) CIL LOCATION SEWAGE PERMIT NO. VILLAGE INSTA LLER'S NAME & ADDRESS I1,✓ 'a i" `i?� �`.�; e�'J- a '� . Z2 L Lice ! . S UILDE R OR OWNER _ t,l DATE PERMIT ISSUED DATE COMPLIANCE ISSUED r •�1 \wp !c ar �I �w � a THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH _-_771 iW_K3.-.---......OF...... A T Cwl. App iration for Bispoii al Works Tnnvtrnrtion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: • .._......, Al l ......�1z-1.1`iF.......................... .............. ........................................................... Location-Address or Lot No. Owner Address 'Installer Address Type of Building Size Lot__ .,45__.....Sq. feet t-, Dwelling—No. of Bedrooms.___. 0..... ..........Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building a Other—Type g ,A1�S?...��?A1NENo. of persons__.__._................ Showers ( ) — Cafeteria ( ) d Other fixtures ----------- ...=.................................................. 55--- W Design Flow________.___.._ __gallons per person per day. Total daily flow_________ __.gallons. WSeptic Tank—Liquid capacity-A®QQgallons Length..... R._...... Width.... ....... Diameter---__ -.... Depth... ..___.._. x Disposal Trench—No_____________________ Width.................... Total Length.....................Total leaching area....................sq. ft. Seepage Pit No-_______(........... Diameter.......t5....... Depth below inlet_____...&........ Total leaching area..................sq. ft. Z Other Distribution box Dosing tank ( ) Percolation Test R411minutes s Performed by.......................................................................... Date........................................ Test Pit No. per inch Depth of Test Pit.... .______ Depth to ground water______'._ __. 0s4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...__-______------------ P� --------------...........--- ------ ------ - .................. Description of Soil......0_P-;l�•-0-•_-•-_.t.Q --.... - Ql�------------------------------------------------------------------------ 1l ------------------r_-.--------------•--I -------------------------- ---�4z ---ef a � 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 further agrees not to place the system in operation until a Certificate of Compliance has been issued.by the board of health. Sed__ ......................................... .......... Application Approved z : ._. _____ l' A__--D•- ate Application Disapp v e following reasons-------------------------------------------------------- --------------------------------------••---...._. ------••---•----------•---••----- • -- -- ...... •-••----•--- -•----•--------••-•••-•-•--------------------•--•--••--•----------•----------------------------------------------•-------- Date "Permit No......................................................... Issued....................................................... Date No..."..= =-.:....... FE$... .............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH «jlsJt�,�... oF...-.. 13A�ZtvSThC�U .......................... Appliratiou for Dispngal Works Tanstrnr#inn amit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ............. �S \U ............................ ..............-c_. Location-Address l or Lot No. �e A.kNGk1!d � ...... & r_TL Owner .Address aAc.. cR �-:_.....--•.........................•- ---'-----..._ .........-------'---•-----•....._.....--------- � Installer Address U �Type of Building �y} Size Lot..Z- ��......Sq. feet ,., g— _--7� __...... ?...__.._..Expansion Attic ( ) Garbage Grinder ( )Dwelling No. of Bedrooms._ Other—Type T e of Building p-, yp g U)OUQ--�W%�No. of persons__..__................ Showers ( ) — Cafeteria ( ) dOther fixtures . . 55------------------------------------...----------------------------------------------------------------------.._---------..--------- W Design Flow......... _ ..____gallons per person per day. Total daily flow____•__-. _...2,Z/-)....gallons. WSeptic Tank—Liquid capacity.h0Ugallons Length-__9..._.... Width.......... Diameter................ Depth__S__.._._... x Disposal Trench—Io. .................... Width ............... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit Distribution box (x) Diameter...Dosing tank Depth th)below inlet....... Total leaching area..................sq. ft. Z Other Percolation Test Res s Performed by--------------------------•-----•------•••--•-----•------_---- ---_.... Date........................................ Test Pit No. 1. Z_minutes per inch Depth of Test Pit---V4 4___...... Depth to ground water____.. ..t_.. GX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ WI....................•_...•---------------------.........._--•---------..........._.........._....._......................................................... 0 Description of Soil---- ;3 ;�-Q®i(�!\...... .......................................................................... V I�.1C�_..� "� .__ t�� a&----------------------------------------------- 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 TITU 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ssued by ,e board of health. Signed. \s (.e.......................................... Application Approved ` � . l ...............- f Date Application Disappeo�ve&for,the following reasons:-----•---------•----••---------•----------------------.......................................................... Date PermitNo......................................................... Issued_...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......�W.w......OF........ �. lU. . ................... (9rdif irit#le of Toutplianrr THISJ C RTIFY, That the Individual Sewage Disposal System constructed (1i ) or Repaired ( ) by 7 ..... !G..// ........ ------------- ------•--............... •-•••------------------------- .._...........--------------- Installer has been installed in accordance with the provisions of T T FF' 5 of The State Sanita/.. a /described in the application for Disposal Works Construction Permit No �.::__ j..................... da.teI._ ______.__.._...___.__.. THE ISS A E OF THIS CERTIFICATE SHALI. NOT BE CONSTRtI ANTEE THAT THE SYSTEHeI L/�iJNCTION SATISFACTORY. DATE. Z. .D ............................................................. Inspector....... ----- ................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .../'4 .............oF... w.. L ..---...---•--•-----........ No......................... FEE........................ ElispoA'al 3&rks 01antrurtion amit Permission,i95&reby granted_" )' r-6.!.K-'!f------.)....-•-•------•-..-------------------------------•--••-------------------......------•--...................-= to Constpud l_ ) orRepair ( ,) an Individual* Disposal System at Ng � ...`.. .... `... ...✓... e-. ....... .........: = Street as shown on the ap i on for Disposal Works Construction Permit No............ ?"' Date&�Z/4't!- ................... ............................f:... . ................................................................._.. Board of Health FORM 1255 A. M. SULKIN, INC., BOSTON' { '51►J61r--�FAMILy,- CBE pRoom DN,,'- --FLOW a IIO x 3 = 3306.Pp 5EPTIG TA►JK =. 33Ox15C>% ;,497;&.P. R �\ USE- loon GAL. ••-�C� 015Po5AL PIT V5E I0,025 SAL. 5 1 PSY/ALL 1 50 S.r, BOTTOM AQI`As . YO -iF•_ 5� S.F• x 1• o �•o G.P o' . �� (J 'ToTA�- �E51 GN s �-2 5 G.P D• � S -TOTAL pA 11-Y FLOW = .330 G•PP PE2CoLATION RATEt I''IN 2MIN o�LES$� �� oM-• Z�i�"3 OF k4lr RICHARD ALAN t(R ��r � RzoF � i BAXTER y IZ W. �l _` I--, \/ 9 No.240480 u JO ES STO" C / 4H� SUR`I�'y ��`L"r' 'TE-�PT gI1G/ �G/.1� To P FWD S, HOLE- EL-Zoo' s � -�� I►�/•11,71,o LoA.wl 1000 INS!- S�$Sol 6 4 t SGPr�C. �'fa17,r Bu,cr::x iv LEAG14 PIT INV. INV. WITH 5g.2 57%4- //�,// I•/31 •1'/z /Vlt�• WAs%4r.D R 6TvN6 , CewrIFIGD PLOT PL.AW PROPILG . L o c 4'T 10!J ��P�iTY�t•�S /,/f l LLS ae' 12 No SC*: t,L SCALE ('I- G'n .. V AT E I�,• 31-gZ, �IO WATER �Zc�POSE� QLp.t.� R,EPE26N G1= 1 �W CLL.I IJ 4,CERTIFY -THAT THE 5N01rYN ► G.QE011 CONIFU?6 YJITN"THE S 1 oEL W r-- 3S AWD SE-te.CK R.6QVIR.EMEN'1'� DF -tµ� "[OWN oF= SAI4fI4;T,Av.,LSAWD 1 OT' LOGp.TED -WITNiW TN N C% •E FLOOD PI-41STG�TZV/LL6 61 G1-lT s D AT 1r 1 8Z el CL 8A.XTG Zd WYE INC- •Tt115 PL&NI 1 �i NOT A W OSTE1Zd1LLTc • ASS• INSTR.UMEN•1" 'sV2.VG-1( �"TI-lE• DFF"SET'S S410uI,? ' NoT DC- V�C•C�To pC"TC:.c'�1►JE. L�Z• 1.-I .1e� APPLIIAr-IT