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Home My WebLink About0072 LAURIES LANE - Health 72-taurres-tane-4 R I Marstons Mills A = 027 107 i �I 7 z-.. Sewage Permit No. Location: 2-J Village: Installer's Name & Address Gt Builder s Name jz Address Date Permit Issued f� Date Compliance Issued �- (720 � d r l . No... �_Dj1q Q r�� _ � FES.... ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH — x ..................... ....................OF........................... -----------........... . ,`y s. Appliration for Uhipaiial Works (go'ntitrnrtiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal�- System at:vt -J.1 �.�l�( ......�CY A.........1...........5.......r..`..... �^ ^( A y�Ig,. 9/firi. /►�P ry C R-O 9�a ?.....r.•�i�__ --- .r �•�� ....... Location-Address Lot o f .:!¢.. '� T a� 33 Owner Address 6 .....-• ---- ....-- �---......-- Installer Address d Type of Building Size Lot...�a aoo......S q. feet U Dwelling—No. of Bedrooms..... ................ .. Expansion Attic Garbage Grinder (Jyj-. Other—Type of Building a yp g .�Y.�-.✓1'1.-:�...... No. of persons.......... .. Showers (. J) — Cafeteria (� Other fixtures ... _ -- ---------------------------------•-.----- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............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 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......--................ Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....................---- .................................................................-•-•----------... --------------------------------•------------ ............:............ - 0 Description of Soil...................................................................... •...............-•-•--------=-••--------------•................................................. U --•--•----•-----••---•------•-------•--•--•-••-•-----•------------------•---------....,.......-•---•------------•-------...•-••-----•••-------•----•---•-•---•--------------•-••----------.........--•- 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha been issued by the board of health. Dat Application Approved By ........... --------•......................................................... --•-•-..- 1.--...�.....•---- Date Application Disapproved fasons----------------•-----•---........................................................................................ ....................................... ----•-•----...-•-•--•------------------......._..--•---------•---.....-•----•----•------------•--------•-----•--•----•--.... ---...---... ..........._.. Date PermitNo....................................................... Issued....................................................... Date u ALA a- NO... ... Fxs.....+....................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. ......._. .......:............OF.......................... ..._....... ,gyp iratioti for Uiiivniial Works Tomitrnrtinn Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal , System at: ....................... I ! ...&N+ ' a�y Location Address :4.4 ° Owner }fit_ ............ ..--- ---- , 1�5 �..� A Installer a m ` Vl'i��.1� Address �' t� G Type of Building Size .....Sq. feet' U Dwelling—No. of Bedrooms.__...lw?................................Expansion Attic ( ' ' Garbage Grinder'"y(; f'G0 aOther—Type of Building ..1'X�' .-.... No. of persons........ ............... Showers a Cafeteria�( dOther fixtures ••------•-•••••••••••-•••-----••••---••---••••••--••--............................................................................................... Design Flow............................. gallons per—,person per day. Total daily flow..............._ ....._gallons. W g -----•-•-•----g P P.• „,,,,,,.,.�Y•. Y --•-•-------------��:- WSeptic Tank—Liquid capacity_.___.......gallons Length':_ �1Vidth................ Diameter-::_.°___....._. Depth................ x Disposal Trench—No. .................... Width_.,..................Total Length..................• Total leaching area....................sq. ft:, Seepage Pit No................ .................... Depth below inlet.................... Total leaching area..................sq. ft.. z Other Distribution box ( ) 4, Dosing tank ( ) Percolation Test Results Performed by, .... ................................... .::..::.:::. :.-._-Date.:::: a Test Pit No. i................minutes per mch Depth of Test Pit.................... Depth to ground water.....................".•-� . G14 Test Pit No. 2................minutes per inch Depth.,of Test Pit.................... Depth to ground water........................ a •-••••••--••------------•----•••--•-••••-••••••-••...-••----••-•-•--•-•----••--- .............------....... .... iO Description of Soil.......................................................................-••---••----------------------------------•----.....----------------..........•---•-------•••••- x 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 operation until a Certificate of Compliance has been issued by the board of health. � .. Si ed- "�Y"'..... ........ ��'- ------ s... ate 41, Application Approved BY `- --- ••..............•-• �l ac .... Application Disapproved for a ollowing reasons: =_ ----------••-------------•--•--------•-••--•------.--------- -•••••-•--••--••••--........•••-••...----•••••--•. �. .. Date'. Permit No......................................................... IssuecL........... ..... ...- .. .v .. _------ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH rtif iratr of T ampliatta TH TO CER Y, the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by ']��Installer-- ------------------•-•--••--•-••---------•-----•--•--•----...---•--....----.....---•--•-•--•-•-- --. . . •----- ----------------•-----•- has been installed in accordance with the provisions of TIT F 5 of The State Sanitary C.. ........ . o a g� ibed in the Sapplication for Disposal Works Construction Permit No.-__17-:.t..�._3__. .___....... dated ��::.. ..�...................... THE ISSUANC OF THIS CERTIFICATE SHALL NOT BE CONSTRUED S GUARANTEE THAT THE SYSTEM WIL F CTION SATISFACTORY. DATE__.....P... _ ----------------------------------------------------- Inspector.. THE COMMONWEALTH OF MASSACHUSETTS f t BOARD OF HEALTH No. FEE_,!.Y.............. R11vowt nr Tun�trnr�inn amit Permission is ereby ranted.----•-. . . -- to Construct (. ) ( }' In 1�3ua1 Sewage D eal System ... -- -••-••-••------•- .... -•••••.--- = Street ,r as shown on the application for Disposal Works Construction Permit N�: .._ Datedt?__:�t�._. ..••..-.... , -•--...------•----------••... - •-- --•-••------••-•••..................•---- q Board of Health DATE_._. / __-- ,�( . FORM 1255 A. - SULKIN, INC., BOSTON \\ NOT Cs' � -qp a// /o�cst,or�s Shown csr� o - faroPo6Gd Or)/ AJ datc/rrm SS) ` (� A q4 . 92 9 /So '',�. 00 � gas // 2 (9 �S 0 .s e- A Y"O U 7- OBI 7-A 7-C- S 7- U L. 7-S --- _ Fe OW ©�--5 /GA./ /A/ Ve- /E'-;P-- EGCi V 97-/Oh/S 6X7 0''e '¢ 2/ 77 er vcsec►i by . 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