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Home My WebLink About0124 ROSELAND TERRACE - Health - !r'�-e�SG eQ tee No ft.. Fss... ,�. .... THE COMMONWEALTH OF MASSACHUSETTS III BOAR® OF HEALTH ............ Q.GV.A...............OF......d ............................................ Appliration for Disposal Works Tomtrn.rtiun Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair (1-*fan Individual Sewage Disposal System at: ------------------ --/'1',� M 2F7a rl 1S------IV!&f...---.........--------........------ ... ti n-Address ................................or Lot No. ....��: ..ZW �n�. � •---------------------- ------------------....................... •ems O er Address , Installer Address Type of Building Size Lot............................Sq. feet DwellingPNo. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type 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.................... 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_--__---___-_-__--__---. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W --•--•••. ------.. i O Description of Soil................ - - - -- - x U .... ...... ....t..._...._......._. U Nature of Repairs or Alterations—Answer when applicable...._�'�.__ / _/ ..._._. ._ _,z .. `'._.._. ............... -----------�5'�a .----------------------------------------------------------------------------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of ilTlj 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued b the Wardje.alth./ ign } .. . s - - Date Application Approved By----- - -----------------------•--------------------------- Date•-----...................... Application Disapproved f r e following reasons------.......................................------•---------•----------------------------••-•-----....-------- -----•---...••--------•-----------------------•-•-•--•-•-----...-----•--.....-•----•-•-----••--•..........................•-•---.....------•-----...---•-••-•-••----•-----•-=----••---------••......----- Date Permit No......................................................... Issued_.................... ............. ------------------- Date � ,No* THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ .........OF.... Appliration, for Disposal Works Tonstrurtion Prrmit Application is hereby made for a,Permit to Construct or Repair an Individual Sewage Disposal System at: .............. ........................................... �Jo n-Address or Lot No. V z, ------------------------------- ------------------------------------------- X/L ...................................................... Owner Address -.2.... tk A...... .... ... ....... 0-1 Installer Address Type of Building Size Lot............................Sq. feet Dwelling2No. of Bedrooms............................................Expansion Attic Garbage Grinder aOther—Type of Building ............................ No. of persons..........._._.......__.__.. Showers Cafeteria 04 Other fixtures ...o................................................................................................................................................ W Design Flow.............................................gallons per person per day. Total daily flow........................................0...gallons. 9 Septic Tank—Liquid capacity............gallons Length...........*..... Width......___._._... Diameter_--_____________ Depth.._.___.__.____. Disposal Trench—No..................... Width.................... Total Length.._................. Total,leaching area....................sq. ft. Seepage Pit No..................... Diameter.............__..... Depth below inlet.........._......... Total leaching area..................sq. f t. Z Other Distribution box Dosing tank Percolation Test Results Performed by......................................................................... Date........................................ Test Pit No. 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......................... ............................................................................................... 0 Description of Soil------....--.. a, ---------0............................0......................0..................................... U ......................................................................................0..............0................................................................................................... -----------------------------------0..................................................................................... 0.............................A . ....................... U Nature of Bepairs or Alterations—Answer when applicable...1--Zia``'____.�Z2 -......... ............... ........................................................... .................................................. .................................. ............ .. ...... ............... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT11" 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued y thyboard of health Signed 4"' ......................... ----------- Date ------- ---- ApplicationApproved By...............................0................................................................. ....................................... Date Application Disapproved for the following reasons:.......................................................................................................0------- .............................................................................................0........................................................................................................... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............................ lw"C'17 ................................... (Intifirate of Toutpliattrr ' TH S S TV CERTIF That the Ioividual Sewage Disposal System constructed or Repaired (,4, -), ..........4, ........... z_. ..... ---------------------------------------------------------------------------------------------- Installer at........./v?. ..... ........... ................ .................................................. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated......_.._....._..__.___.._..__........_.._..... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRI) AS A GUARANTEE THAT THE SYSTEM WI L INCTION SATISFACTORY. 01' DATE--.. ....................................................... Inspector...Z./11......................................................................... THE,COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......Zl,)rl ...........OF..... ............................ No......................... ............. Permission is hereby granted... ........... .......................................... to Construct or Repair (�n Indivqd I Sewage . . Disposal Sy t at ...... ,74;r...................................................................... Street as shown on the application for Disposal Works Construction Permit No..................... Dated.._...._................_............_.... .......................................... . ........................................................... Board of Health DATE................................................................................ FORM 1255 A. M. SULKIN, INC., BOSTON A. �O No...... Fz�$..... 1V...r�1. . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _/�../�L/.--------OF...4� S.748L.c..................... . pplirFation -for :41,15 mtti Works Cnonotrurtioaa Vrrmit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: 2ds � AE/Z12 iN-g... `Z/LLi.. ? 2Z / 1` � o..' c ion dr.s Lot No. O ner - -- dyes -- ------------------------------------------ - -- -----�3 N ' 1 dr.s.................................... Installer Address Type of Building Size Lot-s R.,- ' _ '....Sq. feet V Dwelling—No. of Bedrooms ................................Expansion Attic (X) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons--.-_------_-._----_-----._- Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------ - W Design Flow-------------- >V...................... per person per day. Total daily flow------- .........................gallons. WSeptic Tank—Liquid capacity,1 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 ( ) aPercolation Test Results Performed bY------------- ------------------------------------------------------------ Date---------------------------------------- ,� Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water..-.----------.--_--.- f� Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water-_._-._----.--.--------. �+ ----------------------------------------------------------------------------------------------------.......-................................................. O Description of Soil------------------------------ -------------------- xvC ---_-------1�3'��1 L�---------------------------------------------------------- ------ ------------------ ----a � = ��= - c, - x ------------------------- ----------------------- -- --------------- ----- ------------------------------- ---- -A__-C--1'1_(----------- .................................................... 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 Article NI 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 boar of health. Signe ......`vim ._ .......... ....wllc� .._ - ApplicationApproved BY -----/�------------------------------------------------------------------ ---------------------------------------- Date Application Disapproved for the following reasons-------------------------------------------------------------------------•--------------------------------------- ---•-•-------------•------------------•----- -------------.-----------•---•-------------------•---- --•--•---.-----•-------•------------------------••-----•-------------•- -••----------•----•--- Date Permit No-------/�----� -------•--------------------- Issued------. .„ --- Date No......................... Fx$............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ✓- -------OF......../..1<<.N-.../74f3 4;.............................. Applirtt#ion -for Uhipoiittl Workii Tomitrttrtiott Vrrtuft Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: _ _ W ....................................................10T 1iC E /"JC S!�°lf C /'?/G�- = Ze9 7-..'. . /-------------------- .- cation-Address 'Lott No. Owner 'dress_ - ---- - Installer Address PQ d Type of Building Size Lot a-2-ir,S�_9____Sq. feet U Dwelling—No. of Bedrooms-------�f ________________________________Expansion Attic ()() Garbage Grinder ( ) per-, Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures -11 ------------------`.--.-.____--- _ -----------•------------------------------------------•---------------------------------------------•------------- W Design Flow.............. _____________________gallons per person per day. Total daily flow......./f --------------------------gallons. USeptic Tank—Liquid capacity-/06gallons Length---------------- Width................ Diameter---------....... Depth................ xDisposal 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_.-.____-___-____-__. - rZ4 Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ 0 Description of Soil.....................................................................---------------------------------------------------- --------------------------------------------- x V ..................... --------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------ 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 Article XI 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 boar of health. / / Signed i/ l/ -U it r3 ®-�!� J D 317 s.'.' �.. .. ApplicationApproved By------------------------ ...........................---------------------------------------------- --•••-•••--•---------...----------••---- Date Application Disapproved for the following reasons----------------------------------------------------------------------••-----------------.........-•------- --••-••-•---•••-•-----------•---------•-----------------------•-••-•••••---------•-......-•--•••--•------11----------------------------------------------------------------------------------------- Date PermitNo......................................................... Issued....................................................---- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ o,rc'�°✓...........OF....�T'r9f'NS. 313 G ............................. 0.rdifirtt#r of 0,11mplittttre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (x) or Repaired ( ) Installer at• .11�' ° ��®=r'�` `�/` N'J3 :f� fI'tAC = , /ti'11 ..='�'�/v /'J/LL_• ............................. has been installed in accordance with the provisions .of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL,,,,FUNCTION SATISFACTORY. DATE. �� ' _�E.-` Inspector i . . . v. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -------------------------------------------------------- No.............. FEE. 1)..•----........ .. e i� tt ttl/- -rrrkfrttrtittatrrmit Permission is hereby grante A ------•.........•••-------•-••-•••-••----•--••------•......_•---•- to Construct (X) or R�air ( �an Individual Sewage Disposal System _ at No. .... �..... 1 . ._... /-Gr 1? 3C.4..L..i"1/3. 5� !'� 5 Z!�9 Street as shown on the application for Disposal Works Construction Permit No--------------------- Dated________.__-___--____-___-----____-.-.-•-. -------------------------------------------------. Board of Health DATE------- ------------- ------------------------------------------------------ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS t � �� /arc-c�� 0 7 I PLAA/ � I-C)C4TIOn1 1', /1RSTONS f"JI .LS S c� 'Aj E}2 . .t�� ;. f=off yc_ r rI w: PAANA nrEN EcT R S SNow!/ /71VD Dofz- S C.c�/VrOr'�;; (✓lri/ THE (j�lLG/J�I� $ET/'1RCIC PG4'L'Ir�tlrNTS Or- 7tt t: rocc,N OF P i r; N S 7-t'R L t l � L et ry/ �.1 0 G S o< 57.ov , I i .�OC/I 1-/ON N)(1 R STONS MILLS K b ��•� I Oyu j t i•A F:R �G �.�F� FOP, FvF►tE;7rNRNEN ' z P J•'S,R'4�,a PE RE-RY Gc_R7 IfiY 771r717" 7`Z/C' Ek'/S.T- +P /Alr .FDVNUA71OA! F,CC7 /� S ,4NOwty FIND nod S CONFnI�,•i t�,Tl/ rNE Q0 LD/NC,- SE ,Y-rS Or- Tt/C 7-010N of 1?FRN STF;I Gam. RF"=Cr %LA/J/J SuRv��'ot� ____ - ----- - �.F ?. Ynour}9 P)RSs. LOC&.TIQN T SEW&C,E PERMIT MO. VILLAGE WSTQLLER 5 VA&ME ADDRESS jq 5U.1LDER5 tJl VAF- _DIaTE. PERM T_ 15SUED •— D ATE COMPLI &,MC'E ISSUED : E7:1--/- -1 .I� v' ..�