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Home My WebLink About0081 LAURIES LANE - Health �j �,�,�,��. � , � .m:ils -- - - - - -- oZ� ��Z .,1 Af� :� _�� ^�� \ 1. V -01-1 N . LOCATION SEWAGE PERMIT O VILLAGE alp INSTALLER'S NAME i ADDRESS 9 U I L 6 E R OR OWNER DATE PERMIT ISSUED s�f� DATE COMPLIANCE ISSUED -7 �4Z t. ,c=t�h � . d ��qqY ,� '9Aa'� ��Q b 'Y ,. :s / ��•J ••``YY� Y�i 1/ _ oz ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH • , .-•................. .. --------.......OF....................................... Appliratiuu for Biiipoii al 10orkii Tutaotrurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at:. ................�Sf�....:2 - ...... 4mz !.�✓: 1 :..M t GG f = ....... Location-Address or Lot No. 1_� __..N_�:e!-N-----...... --- 5'. -----•--•------ ...---•------------------------------•----•---•----...-----•--....---.....---•------•----...-•---- Owner Address a ------------------------f�`.....C247 !------•--•-----------------•-- Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms...._ F Expansion Attic ( ) Garbage Grinder k40) Other—T e of Building No. of persons............................ Showers a YP g ----•---•------------------- P ( ) — Cafeteria ( ) dOther fixtures -----------------------------------•------•-------------•-------------••-•----•-------............................................................. Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity .P-.�gallons Length................ Width................ Diameter----------_..... Depth................ x Disposal Trench—No..................... Width.................... Total Length..................... Total leaching area--------------------sq. ft. Seepage Pit No--------------------- Diameter.._. e!Z?____-_-__ Depth below inlet......-E.,__......... Total leaching area..Kv�.......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ �-.l Test Pit No. 1_G_______...minutes per inch Depth of Test Pit..../?-.._..... Depth to ground water....A_,O 5 "___. (ZA Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ C4 -----------------------------------------------------------------------•.._..-----•-•--••.....--•-•-......................................................... 0 Description of Soil...........................................................•-----•-----•--••-----------------------•------------•-----------------------------------------.._._......__. x 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 iITi U 5 of the State Sanitary Code— The undersigned further agrees not to place the s s em in operation until a Certificate of Compliance has been issued by the board of health. Signed_.22 ............................................ Application Approved By.......... a 1 �"`9-------•--••---•--•-•-•--••------------------ ......................................... Date Application Disapproved for the following reasons:--------•-----------------------------------•--•----•---...----•---------------------•-.._...-••-----........•-- -------------------------------------------•----....---------...-----------------•------....--------_---... ---------------------------------------------------------------------------- Date PermitNo......................................................... Issued....................................................... Date 49 No................ ....... ..................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH P �- ..................OF.......................................................................................... Appliratiun for Uiipuual Works Tonstrnr#ion Permit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: J ..... ......... ................................................•------- .... ...••----------•-----------------••-•-•----•---...-----•---•-••..........-•-- Location-.V_�4 • ' or Lot No. ....---•_..../(/U /� �-N•-•-•---•...............................•---•--•-•---•• ...._......._ ........ -------••-•-•-•--•--. ............... Owner Address W Gv 0/9./c L 6 ................. ......... Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.,_..................................Expansion Attic ( ) Garbage Grinder 46 ) Other—T e of Building No. of persons............................ Showers — Cafeteria Q' 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..../O......... Depth below inlet......-.1�_........... Total leaching area.L!?:°.......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by....................................................................._.... Date........................................ aTest Pit No. 1.G.L:____minutes per inch Depth of Test Pit.-.Z ..*...... Depth to ground water----A_to_n-[-`---- fZq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -•--------------------•---•...-•-•---•----------...._......................----•-•--•••---...................---------•-•---------......._.....---•---- 0 Description of Soil......................................................................................................................................................................... V -------------- •------------------------- •-------------- -.------------------------------------------------------------------------------------------------ ----------------------------- 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 TIT iL 5 of the State Sanitary Code— The undersigned further agrees not to place the s s em in operation until a Certificate of Compliance has been issued by the board//of��health. Signedd. ..�/,.e�� a Application Approved By......... = -C .---•-••-•----------- Date Application Disapproved for the following reasons:................................................................................................................ ••••--------•--•-----•----------------------•---------•-----•---.......---••-----.....................-•-'---•••----------------- .......................................-------------------------------- Date PermitNo............................•---------------------------• Issued....................................................... Date ` 1 THE COMMONWEALTH OF MASSACHUSETTS ` BOARD OF HEALTH ..........................................OF..................................................................................... C9rdifirat a of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) Installer J has been installed in accordance with the provisions of TITIZ 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No---- ---3_'�d................. dated---..____-._._--__-___-------__--_---_--.------. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM 1Allt FU CTION SATISFACTORY. DATE----�'� -�2 .. ,1.................................................. Inspector................ ................................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 93 ..............................OF..................................................................................... -� C No......................... FEE.. l Disposal Workg Tonutr ion rrmit Permissionis ereby granted------...= CO `.� •-----------------•---------------------------------------------•-••---------------- to Construct epair ;'c) as Individual Sewage Disposal System Street as shown on the application for Disposal Works Construction Permit No........../......... Dated.......................................... t . • -- ..................................................... Board of Healtle DATE....................... /AIIEN. -FORM 1255 HOBBS & INC.. PUBLISHERS �'�� LEACH / ASS 5.Y = e�a y — nit lr7c/mo1!>/;179 exParr`s,on_ Vi 11 1 00 '►� 1 �J ✓ 41 (/ 0 i Too o� �"s,�•.�o•s>�ti �. 9G•o ��' SELt/r4GE G�9YovT Oi9Tf� TEST" HOLE —i000 9a/ loan-/ f scib5oi/ c>ut .C7• c �v' _ `�s YS �7a `.Sa.tE , e-r7c ':ear. 7`Precf -- �i�stribu �ior7 boX Perc-. rc�-t-� C Z M/•�./ir�c o v t/e e✓ = �3,i c�,z,,�! ram -cH z E a2�. �2- -�/) , .- washe � Sf'onG a , �+•-• I bo1`t0rr7 of Pit CIVIL to No. 307fl2 ESS«NAL NOTE : u.// /ocat/or-7S Shoµ'n a�G Pr•o`ooSCd on/r' _ _ all- /000 9a/ a,STribv7�.on box ° sc ale- ;� _ /,ft �c a c h washed ' ' • �� P� f • ° /o S S"c cz le / "= 3Q" c"cz/`e : f�0 6 U 5 T' / 9 7 j Gt�y��40 Ll eE- 46 /,-7 cP : C O T A! B O A,2 0 O F He"'9 7-A--1 GALI, K Y t- Ti9 7"E — — — — — — da f G OF GAMES , i " BQWMJIAI y { �,f✓i� �>�6/�t14��5 claw � ,moo v r� 6 A-•- yi9/E'M o v TH , /�•�li95 S. �a 7`'� �`'"' ' f- — — — - - -