Loading...
HomeMy WebLinkAbout0567 FLINT STREET - Health 5l� Fl iW �f ' • t .� '-` r ' .ram ♦ V LO CAT WN' rjf `_- V�J SEWAGE PERMIT'• M0 YI '. sAG jo- FIST : P A M E A ADDRESS % ti 0 UILDE R OR OWWUZ o 1�F2 DATE eF ;' IT ISSUED S m zo -Y5 DAT E COMPLIAt � E ISSUED L� J�k . ' G No...... 5:.I � ® L�O Fps...... 5� THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ' .............. ........................OF.................... �*;A Appliration for Diap.a,ial ,arks CI.anatrnr#inn unfit Application is hereby made for a Permit to Construct (Y) or Repair ( ) an Individual Sewage Disposal System at: -.--L c3ti n-Address .......-•------••.........................or Lot No. �-....................•---- ............................................... Owner Address as. ...0 ...... .m........:�---------------------------------------- -•--------- -----------------...........---......------ Installer Address d Type of Building Size Lot_ O,e_ .O .......Sq. feet U Dwelling No. of Bedrooms.............;?............... .....Expansion Attic Garbage Grinder 00 Other—T e of Building ............................ No. of ersons.................._.___.____ Showers — yp g p (! ) Cafeteria ( ) Otherfixtures ------------------------------------------------•-----------------•--••------•-----------------•-•------------------•-••--•----•------.........••---• W Design Flow............................................gallons per person per day. Total daily flow__-_t- � ...........................gallons. C� Septic Tank—Liquid capacity/°....®gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total.leaching area....................sq. ft. Seepage Pit ..... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.........�'S�_X C!�.....4-._._&Y-1----------- Date_._ I y.. 1._._.-�� Test Pit No. L...............minutes per inch Depth of Test Pit.................... Depth to ground water-----------------.-__._. rXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W . ................................. O Description of Soil.......... -6 °C�?d "`" 'y / -•---••----•-- .��/©.....i�t_R � 4- .....P 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 TITIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operat' until a Certificate of Compliance has been issued by the board of health. HIlowing ------------------- lpDate Appl. tion Approved By--• ------...... •-•--- ----------------------- ---•-� 1- -DateApplication Disapproved for thereasons---------------------•-------•--•-------•--------------...-------------------••----------._Da------........-- ---------------------------------------•--------------•••------------------•----•--•----...._.......----..__....._..........------------. ----------••--•-•----------------•-•-----------•--------------- Permit No........ .71®S........-•-------------- Issued.......��• -------S Date------- Date No.........`I O FPS... `... y rr `- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH M. ......................... ................O F..................................... ......•... ApplirFatilan fur. Uiijimaal Worko Tnnstrurtiun Primit Application is hereby made for a Permit to Construct kko ) or Repair ( ) an Individual Sewage Disposal System-at: , .......f ..� .. y ... �Ll ...... ........................... '------------. . ---••---...---•._..._..................._. -- Lo f n Address or Lot No. Owner Address a " ...... .® t.:l........................................... ...................... ...... .. Type Of B Installer Address d yp wilding ize Lot.__._.t....................Sq. f et Dwellin No. of Bedrooms........... ............................Expansion Attic ( Garbage Grinder aOther—Type of Building ............................ No. of persons............................ Showers Cafeteria ( ) dOther fixtures -----------------------------------------------------------•-----•......-----•-----------•---•..... . w Design Flow............................................gallons per person per day. Total daily flow___ ®.._.__.__.____..__.....___._gallons. WSeptic Tank—Liquid capacity/aPpgallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No....................: Width..................... Total Length.................... Total,leaching area....................sq: ft. Seepage Pit No._!© G__.. Diameter....'................ Depth "below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ,�/ Percolation Test Results Performed by..__..__I A !C' ' ........_...!t_��-._...___. Date_.��`��.._��_.._.��� Test Pit No. I.._......_...I...minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ RS ................... ......_ ............. ...........:.......... O Description of Soil----......p. �'�- _ matte-_-•� � ��-----------------�~/Q .oI��PS�' -�� ... 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operati un '1 a Certificate of Compliance has been issued by the board of.health. Sed --..e . ._..crr....... --•- .............................. .......................... PPlic' ion Approved B - -"` " PP Y = ----- .................................. Date Application Disapproved for the flowing reasons:...................... ............................................................ ................................••-•.......----•--------•-•...-----------......-----------....------•-• --- _-•--• --• --•----•----•. --•--•-•-•------- Q. Date Permit No........ -lL �------------- -- Issued.: ."'-'±. -- Dato _ THE COMMONWEALTH OF MASS ACHUSETTS BOARD OF HEALTH OF,:•:::.............................................................................., Trr#if iratp of C ampliaattu THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed Kor Repaired ( ) bY..................u........................ ` -= ...............--------------------------------------------------------------------------......--------------...-----.... Ins al er' at---•---•---•....... .F.t ........ ..... ....... Y. I" !//.' -................................................. has been installed in accordance with the .provisions of TITLI S5 ofp�e State Sanitary Codes d,#scri, S5 in the application for Disposal:-Works,Construction Permit No..........._6_--_-___-•_----•------------- dated.................................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............ - f°� - ................................... Inspector...--------....... C............................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............O F..........•----- i No......................... ............................... ...........---•-----•-------•-----.................................. FEE........................ Bisp sal Works Taan,atrurttlan rrmtt Permission is hereby granted................5 .....R..... +�--_...____...._.._.._.. ---•...............•----.........--•..............._._... to Construct (�or Repair ( �♦an Indiv ual Sewage Disposal System - at No.............+�ama!`.-•........ ' lit!' '" � 'A.P �_vs?r r//�ss .......... .:' Street r`� � t,. - as shown on the application for Disposal Works Construction Permit No.____•--------------- Dated.............. _.................. :. F --------•-- ---•--.---- ---•--•---.---. Board of Heavlth DATE................................................................................ ' 'r FORM 1255 A. M. SULKIN, INC., BOS ''TON ,. 5iQGtL— FAMILY Wo .GAQ.BAGE 6cz►NOECL vtm FLoW s 110 X :5 Z30G.pv Y I'' rjEPTIG TANK = 330x15o'/. = -497 G.P � �26 ,� U$� loon 6AL. LC�t Ir2 01,5po5AL PIT v5E tvo0 2`4 375 G.1'o 9s �Z•a 9/ a 9-EA- 0 5 F, •� 5 - i -TOTAL_ D5-51(+N = --25 G.PD. -ToTAt- DA 1 LY Ft-ow - 330 G•Po - �� 5 we PER.Gol.AT10tiI MATE : I'1IN 2M1nr O�1_ESS OF MASI OFf PETER ��: �d►�` `96 � �S� T.M-� SULLIVAN H RICHAARD \ '73.0 No. 29733 BAXTER t No.2404640 +r 95 3 �FSSrOMAL E .1 �9 Q�STE�r 1-3177 --77 .-78 -7 • — E+-lO�t6 A�i� 9-E?-A4Z AtLL TE'�T LAsq.5c.1rTh�1-I_ MX7\-SZkA-(C -(402 \0 s' q3T NoL� Q-37-77 vQ l,L s 0 TW 91-0 1000 DIST. INS C, 90.G TAnJK �I ��SOtkj GAL. 1 L�AGLI J i, INV. IWV'. 1D 5 j PI'r �•2 90i4 ►�,N 1L vJAsuta� ,� s `( 6 ro N c- CEQ.TIFtGD Pt-oT PLAQ w I�I Tec. L o 4 A-T 10 tJA4 Q?—S-rDrJS IA t Lt,s o 5 Gp..t_E s CA t:a ►.10 aTm2 Cam, P�-p.t.7 REP E26tl GE C E FIT l Y -t N AT -T N i l"lam 5No WN uE2Eo� GoMPLYS vJ1-rp-t E S I aSL%W r-- AUP SETcEAGK ZG Qultz�M>rNt'� 'jo W N 01= �,j n LOGp.T D •WITw11.1 15'T�Q6'D'LA"D S u svrzy�-y � �►� ©FrS S4t�vL-D [JOT 736 05L-� 0STE2VILLE-: � IKASS - LOT- LitisS, App�- c -J- %I I ,