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Home My WebLink About0099 PEACH TREE ROAD - Health qq MCIhs7'bns 1 I L O CATION ] SEWAGE PERMIT, NO. VILLAGE 0-?'3 INSTA LLER'S NAMEADDRESS BUILDER OR OWNER ivy DATE PERMIT ISSUED DATE COMPLIANCE ISSUED ��o� f a � .,, ,� �� - � � ;� ` No................ Fss....3 .......... THE COMMONWEALTH.OF MASSACHUSETTS BOAR HEALTH iJ..............oF........... hiZIA/ST /�-:..----•--------.............--- Appliration for Disposal Works Tonotrurtion tirrmit Application is hereby made for a Permit to'Construct ( ) or Repair ( ) an Individual Sewage Disposal ystetn a F�1c 12...E ..r .�....-•............................... ................. ------..............- .......... - ._.....----•- •-••----•-•-----•-. Loc!a?�'` Add=., or f No. (� •- fCcTS c �� .. .c>`J T-.. ...: ....................... ........... ......_ Owner Ad ess Installer Address UType of Building Size Lour Sy��......Sq. feet Dwelling—No. of Bedrooms............... ___..Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) � Other fixtures ------------•--•-----------•-•......-••-•--•••••. -•-.......----•----•-------•-•---••-•--•. W Design Flow............. _...... ....._...gallons per person day. Total daily Aflow............. .........-.........gallons. WSeptic Tank—Liquid capacity...�.gallons Length'._ -J-_... Width._Z1....._---- Diameter................ Dept,15.8....... x Disposal Trench—No..................... Width_..._...�._...... Total Length.....................Total leaching area------__...__... sq. ft. Seepage Pit No....../------------ Diameter....... __ .... Depth below inlet..�a............. Total leaching area.......... ....sq. ft. Z Other Distribution box ( ) ank ( ) a Percolation Test Results Performed by... +4?�..�. ...�.._ .� N S Date...........••--- 7/TA-- Test Pit No. 1................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........................ a r O Description of Soil--_•.---��-.... cA 5�---- 1Z�.... U ......•-••--•••----•............................•... �bc.-�'c = w x .........-•................•--••-••-••--•----•-•-••--•-••••-•••••-••-•-•••---•••-•••••----•-••-•----•---•-•---•••-•--------•-•••-••---•••--••--••-•-••-••••----•-••--••-•••••......-•••••------•---•-•. 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 iITL 1Z 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issu�thd- igne ........•-----.-x,�'_�..1w._........ . X ... Application Approved By.... --G4 - -------------------- /_...... .. '-------...... o c_ Application Disapproved or t e following reasons:........ .. n r Date Date Perrr:'�ANo..... Issued-....................................................... Date �L No... _ y.. Fizi3 .3-3�.......... .� THE COMMONWEALTH OF MASSACHUSETTS BOA OF HEALTH fEua-...............OF.......... ..... ST O/- .. Appliration for Uhgpaii al Workii Tututrnr#ion Prrutit Application is hereby made for a Permit to Construct ( ) or.Repair ( ) an Individual Sewage Disposal ,Sys te�1Fl va I vz �� cn-L-y Z...� Loca Add essr-- or o. � 5 M. n VS 1- f t tfO+` - _ 7.._ ._. ................... ..........•••_..... ><1....k:.l ?............. ..... .................... n 01 er Address ►W.1 .......................... .................•---•-•.__._.`��t .• G_t�'t F_?.4?.iLl CAS S ............. ....... ..................... Installer Address Type of Building Size Lot---------5;�1_t>....Sq. feet U Dwelling—No. of Bedrooms............. -•__ -_ -___•Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building .:_: No. of persons_...•_______________________ Showers — Cafeteria a' Other fixtures ---•••. Design Flow....................5 ..........•_.gallons per person per day. Total daily flow........ __ .U gallons�� WSeptic Tank—Liquid capacity/��gallons Length.._._.._____ Width.lL...o... Diameter________________ Depth... x ,Disposal Trench—No..................... Wide.:............... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......C............ Diameter:._-•....C:_. Depth below inlet........G.._.... Total leaching area... .....sq. ft. Z Other Distribution box Dosing tank `" Percolation Test Results Performed flx_19.._M.L."......�_.......na�:�S..... Date.....-S..l-!-�.-(.�_..i W Test Pit No. 1................minutes.per inch Depth'of Test Pit.................... Depth to ground water........................ Test Pit No. 2.......0........minutes per pinch Depth of Test Pit.................... Depth to ground water........................ •------------------------------ c ------------•••..--•--..••-•-•- -41....... O Description of Soil.........�r.. K?!tir'... - c 1-1 Z Z ..... 0.K Q. x ---•-•......-r��...............•----•------•--•--...... U %- 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 TITI.% 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 t oa i g 2, i ne :: .C..� ......... f/! � J Application Approved By....�� `. . `..•--•_•_•-••_-•_.-•... t 4 Date Application Disapproved f r t e following reasons:..... .............................................................................. .............................•----._._..._ Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BPABD,,OF HEALTH 4 5....Cl ?N.........oF......r.......... .N ........................................... Trrfifiratr of TompliFanrr THIS IS T(�CERTIFY, That the Inaividual Sewage Disposal Sy constructed ( or Repaired ( ) by..........•••--•--••-•-----....•-•..IA?� io-"` `�..... -----------S--k £ s at................ �......Z ------------------------. �;*� has been installed in accordance with the provisions of TI r he State Sani ry Code ed in the application for Disposal Works Construction Permit No... _..��.............. dated__.._��._._. ..._.._._................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRU D AS A GUARANTEE THAT THE SYSTEM 1Al)LL F NCTION SATISFACTORY. DATE/9/r,3....................................................... Inspector.. THE COMMONWEALTH OF MASSACHUSETTS BOARD.........6Z ..................OF ........................................................................ F H T No... .. ........... FEE........................ i o r n trrn rrmi# Permission is hereby granted........................................--- -------...................................................................................... Construe( orgpair an n "'dual Sew , isposal Syste .........................• •--•-•----•...•-•.........•••.....•••••......... r... .... Street All as shown on the application for Disposal Works Construction Permit No................... ........' .f�...................... ------------------------------•-•-•-----••........... Bo of Health DATE.......................... ....................� ---�•�,� , FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS A '51N6Lc FAMILY - :S BGORooM Q4 DAIh MOW : 110 x 3 = 3306.P0 SEPTIG TPNK = 330x15o'/• =a95G.P. o ► Z`I ` rf _t USE loot GAI-. Zp g,3 �• (� D1 $POSAL PIT V5E 1000 GAi-. M�.,�RN. r ala ` • 51 DG•w/AI,L ATtGA. 1�o S.F..,_ ' •�,ti, f . 15o S.F, x - 50TT0M AV-F-A 5� S.F.• x 1• 0 5o G:Po' • - � '= w ((ra -TOTA1-. oESIGN v .4.25 Z �o O �'twpw r,a /PRoP• W -TOTAL DA it-,? F%-ov4 = �330 C.PD. 01 PE Z CoLATION RATE: 1"IN VAIN oV-L1r 55 0 ` O 40 d `N Of a � pL�OF per' WILL yG, /►lAN / W. c0 � nr E I ��o, ,p No. 19334 G (NJ-0' . 25 �L�- _ SC 1 �► v�nEP Nate �v� � • i su i! II TE>T 8 �G G Top FNu=7o,oo GT I! eu0 SOIL DIST. INJ G GG.B BOX ScPT C. I000 T::7-- wvl. �.G.•T 4 o LEAcu I� PIT INV. INV. I MEDIUM 4I;.3 G t,.b � wlTu I WASKco 6Told6 I (oO.O II GEitTIFIGD P1.o-r PL.A►J PROPILG - . LO[A-TIoM µARSToxS M1LLs• �r5, 8 NO. SCALE SCALE 111c.60Ft.. PATE 9JI-7 !8 L N o W A,-e is T2; s/II / e1 PL.AnI REPE26NGE GERT1FY TNAT THEPRoP. F604VATt0116N0WN NERFso►•1 COMPU(5 WITH"T HS S I T>I:L%W E LOT Z-1. A W P S�'T5ACK R.6QV1R.1~MEN'1'� oF -tµt_ -FLA,M FOR, ALAN E. SM&LL IKC- -ToWN 1 1AOT 1 LOCp.TE D :ttWPAT T�I jTNI ' _ R.EG1STF- Z.6'D I.AND5ur-vEvoe .I �! -TuiS PLQN I�i ^Wort gn5C oa AN p3TE2.VILLFs - MASS• !, Iu5TRutAeWT Sv2VGY �- T145- OF:V ,F-75 Su d out� aPPLIA ,►doT DC- v9 -•D0UT - - IC _ RoBSPTS lKSNLT`( T�. 7 N I • I TT/C w � ._._.__.._...___._.___._.__.__.__.._-._............_......_._.___._._._.__._......_..._._._...._......_.._._.__...._._._._._._._..._.,.._.__..._._.._._...._._._...._..._.........._._..._._...__......__.._..._..__._.__.... Ll 8�5Z