HomeMy WebLinkAbout0845 OST.-W.BARN. RD - Health 845 Ost.!W
Marstons Mills
A = 124-028
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINALS)
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THE COMMONWEALTH-OF" MASSACHUS S
BOAR® OF HEALTH
T�.t n�...............oF.....,.... ..i�9---8_6. _
� 1.
, ,
`y DarApptiration for Uhipoii al nrko C�nnitrurtion ami tom,
� Application is hereby made for a Permit to Construct (Io�or Repair ( ) an Individual Sewage-.Disposal
System at:
................ o T ..................
...
Location-Address p or
se�dn/(�------.-- tt:,------------------------------- --.... 9...:d.�_.�✓,�.���.----- ��................................
caner �/f/J�f Addrd6ZJrta�°o W .. ........... ......--...! &Iiat........ .............. -•-•-• _ .. °
Installer Address
dType of Building Size Lot - .....Sq. feet
U Dwelling—No. of Bedrooms............................................Expansion Attic (yp) Garbage Grinder (W o)
Other—Type of Building ..N/A............ No. of persons.............................. Showers ( ) — Cafeteria ( )
a Other fixtures ------------------------------ - ..
-----
W Design Flow-------- /�........................gallons per�n per day. Total daffy flow-:----•-•.3-'3-0....................gallons.
�r
WSeptic Tank—Liquid capacity/47k;V__gallons Length. !z...... Diameter................ Depth.._a-_•_6_..
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No------/.......... Diameter...6__'__.---- Depth below inlet...6. ........... Total leaching area.,2_0-0-..sq. ft.
Z Other Distribution box ) Dosing tank ( )
Percolation Test.Results Performed by---��d�1!/g ..._1$.-_.4lia`l-Q ...&-. " Date...._. �4, '�*......
.
aj Test Pit No. 1.e..Z...minutes per inch Depth of Test Pit---/-�L--------- Depth to ground water.../V—O-,, .e---.
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
R+' •--•--------------------------------------------------•-•-•---•---•• --•••-----P ------------•----5-1-•-`--------•---`.I--------------.--.----!-_--•-------
Descriptioniof Soil------ _ -- ..tt> � J -60...---1 41
U ----�.Irv.b--•----/��1,1.P.�........LiC�:SEZ----� �/.��---r------�-Q--�-`-�-/`f_.Y--.`�_._..�2_�1��t�d.�t..�.�c1�$-/_�_S_
W /9 ---------------------------------------------------------------------------------------------= ----
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 TL I'L U 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.
Sied.-- ... -•-• - ------------------------------------------------•-•---•--- .........................._....
ee? Date
Application Approved By--- • .6, ...... T-? �
Date i
Application Disapproved for the following reasons:....................................................................----------•-=-------------•----------------
Date
PermitNo......................................................... Issued.......................................................
Date
.. 11
� I
THE COMMONWEALTH- OF MASSACHUSETTS
BOARD OF HEALTH
4:1 Lit .l4}................OF.........
Allp ira#iun for Bispaa al Works Towitrurtiun Urrmit
Application is hereby:made for a Permit to Construct (.101) or Repair ( ) an Individual Sewage Disposal
System at:
...............tea r-
'
Location-Address or Lot No.
.................................................................................................. ...........................•••................_•-•-........_..--•......................._.........
Owner Address
a •••••-------•-••.......................•--------••-•-•-.._......•--•-••........................... -----••-•—••••-•••---•.....•-----•-•-•_..••••-•••••••••..................._............._._._...
Installer Address
Type of Building Size LotZO.R....-`~ q..-:______S feet
U Dwelling—No. of Bedrooms------3..................................Expansion Attic alp) Garbage Grinder (Uo)
p., Other—Type of Building _.N:/A_____________ No. of persons............................ Showers ( ) — Cafeteria ( )
Q+ Other fixtures ......................... ......
----------------------------------•-----------------•---------•--------•--•-----------
W Design Flow......../!�a........................gallons per p n per day. Total daily flow......... r....................gallons.
WSeptic Tank—Liquid capacit}✓ONN-.gallons Lengtl .~e5.0.... Width..V.%®.".-: Diameter................ Depth...5....a...
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No......o�!........... Diameter._ -_--------- Depth below inlet._a.............. Total leaching area.P—.Q�_..sq. ft.
Other Distribution boxer) Dosing tank
'-' Percolation Test Results Performed by. qn%_! <P...4-.. lF r A ........:In Date_.........f�5
aTest Pit No. Lie.. -...minutes per inch Depth of Test Pit._ ._r.__..• Depth to ground water../V_0 V.jC__
(s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
oil
O Description of Soil......Q..---4 .Y .. �!,� '1� .�./41 ---....�G�J,���r� � �.....'-".�'�_ ���'���`v_�.
U1➢tu. ......../.1.41Z......... C-I.0&Z...-. ........ ...... Cat?A.�
Wh' ------------------------------------------------------------•------------------------ ---------------------------------------------.-----•--••------------------------.--
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 ilTLE 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.
Sied .....:.......•••-••••.......------.......--••-•---•--•-•------ ------••-•-•--
Date
Application Approved BY `..................7_5�' ............
! Date
Application Disapproved for the following reasons--------------_-----...........................-----•-----•-------------------------------=•-•-••.........--
................................
...-••••--•..............•....; f ---------------.........-•---'----------••--•----------------_--- ---------................................................
Date
PermitNo......................................................... Issued........................._............=-•-•-------•--•-
Date
,.c
THE COMMONWEALTH OF MASSACHUSETTS
_ BOARD. O HEALTH
:..........O F.................:. . ..... .. .........................................
ITrru irat of T mpliFanre
THIS IS T CE IF a he I '.v al 'a i s ystem constructed ( ) or Repaired ( )
by.............. .._ . -----•_.... ----•-• --
- .....
5t er
at. �, = • - ......................................
has been installed in accordance with the provisions of TI" q ale State Sanitary Code, esc n the
y 63 sC .... ._..
application for Disposal Works Construction Permit No.._._L__ ________ _____________ dated_...______._ _____._...
THE ISSUANCE OF._THIS CERTIFICATE SHALL NOT BE CONSTRUED,AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY:
��
DATE....... .. .............�......._.... '.-.........._. Inspector.... 4—
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OFe.4JEALT
00
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..,.....OF................. ...............................................1FEE._. .l....
Ru11uuFal ku u iun rrmi
Permission is hereby granted............. ••....
to Constr ( for Repair ( ) an In ividual Se age Disp st
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at No...: �i .�:... a
treet
as shown on the application for Disposal Works Construc09,tion P t 1' _____ Dated.._.__.__.__ __ .__. ....
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B:: oard'.of Hea
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DATE--------- ------------- -•-•• ............................. •-•--
FORM 1255 HOBBS & WARREN, INC., PUBLISH S �vO„
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