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Home My WebLink About0230 ROUTE 149 - Health r230 Route 149 arstons Mills = 078 — 071 — OU2 1 0"l� -fib ��.a.n ✓ No. Y..Y l .�.. - - FssA.J�!_............ _ ' ... r` Z.HE COMMONWEALTH OF MASSACHUSETTS ��IJ = BOAR® F HE TH y l ----....-...!!--.".......".............OF.................................... �'S............................................... Z I ^ v'7 1 *' ApplirFa#inn f nr Dispos al Works Tonstru.rtiun ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual 5ew�ge Disposal , `.•System at: I �� _ �Lr ............ ................................ ... ... .....A. .... ... ... ...... I .......i.........'...... --- .......... ..... SJ ......••^..... . •... ...... �lY!V ••....... .......... .......�!�.._ :V ..�s/ �.. A '.A er,- .......•....... !.!.f. .'!!✓ /U P IJ. Installer Address Type of Building /�� Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) O.ther—T e of BuildingNo. of persons............................ Showers a P (....)..— Cafeteria ( >. Othe�jfi --------------•----------------------------------••------- W Design Flow.........S ......................gallons per person per &y. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity/ allons Length-------Q.-..._ Width...... _..... Diameter________________ Depth-:::-:-:_----_. xDisposal Trench—No. ................... Widt ..---------_-___-- Total Length........._._. Total leaching area.... .l�......_sq. ft. Seepage Pit No---------'-------- Diameter.....1�___._...... Depth below inlet...... Total leaching area. , ..sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results' Performed by........................................................ ""� ------------------ Date-----------_......----------••-----•--- 14 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........................ Description of Soil �"....... .........................d.......-.-.-.-.-.-.-.-.-.-.W - ..... 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 U 5 of the State Sanitary Code he and s gne urther agrees not tjp1ace system operation until a Certificate of Compliance ha n s by o d ealth. ign --... •. •---------. .. ---......................... ateApplication Approve . -- ---- ----•-•--------------- -------------•--------....------------------......-•-------- ate x Application Disapproved or a following reasons:-------•-----------------------------------------------•-----------------------•--- .................. .....••------•-...••---•---.....----•---------------------------------••--••----------•------•----•------------- Date PermitNo......................................................... Issued_....................................................... Date u ob No. Fm� HE COMMONWEALTH OF MASSACHUSETTS SOAR® �" HE T .-.... oF....... .................. •......................•------- Appliratiun for Disposal Works Tonutrnrtion ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual SevAag , Disposal System at: � � V1 � )1h ionA r ......................... - /) ...�. ..' ...-� ................. ► , �. ..._^_.......-'G� ---. �t Oy_� e _. ....... -•-----•- ---. .-. ....-ka 5.............•............................• W ................ ....1..•�'...,1..7...�,t�A`�'`� ......^^....--.......... ''�t'� � .� � Installer M1,. Address UType of Building , j� �*► Size Lot............................Sq. feet ..� Dwelling—No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder ( ) aOther—.Type of Building ............................ No. of persons................._._..........Showers ( ) — Cafeteria ( ) Othe '•••-•-------------•-•-•--••.......--- •--- ... ..... .......-------------•---.....-•------•.......-•------ Design Flow..... ..._ .__._gallons per person per-day. Total daily flow gallons. WSeptic Tank—Liquid'capacity/ allons . Length...... ........ Width......rce...... Diameter................ Depth................ x Disposal Trench—No .................... Widt1 ....__.... . Total Length........ Total.leaching area....................sq. ft. Seepage Pit No..____._ .......... Diameter___-- --.-_____--_ Depth below inlet.....1 --------- Total leaching area.( ---sq. ft. Z Other Distribution box,(,1) Dosing tank ( ) aPercolation Test Results Performed bY.................................................-........................ Date........................................ 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....................... / .... j t D Description of Soil-• ---.� _ fi ----- 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 TITI..L 5 of the State Sanitary Code he and gne urther agrees not to place t e system 'n operation until a Certificate of Compliance ha a is by o d ealth. . yt,,•' ignw• ---•--..... .................... .. _ Dat Application Approve at Application Disapprove o� e following reasons------------------------------------•-------------------------••---------------•----•-•-•••-D ...-----...... ....................................-....... ----•-------------•••------•---•••---•---•.......-•-------------------••-----•-••-••----------------•-•-•---•---•---------•--••••-............--•----- Date PermitNo......................................................... Issued....................................................... Date T E COMMONWEALTH OF MASSACHUSETTS BOARD f ,F, H A j H ..........Ze ...........OF..... ...�."t.ok.. ........................................ dw Tntifirtt#r of Toutplitture THIS IS TO CERT ; hat the divi 1 S va Disposal System constructed l�' l or Repaired ( ) by--------------------------------------- - �" 'f�__I.- ...... I staller Oli has been installed in accordance with the provisions of T TIF of he State Sanitary Co as s ribed in the application for Disposal Works Construction Permit No. `+ _ ^�. .............. dated: _._----- _.__._.._...____._._. THE ISSUANCE OF. IS,CERTIFICATE SHALL NOT BE CONSTR E® AS A GUARANTEE THAT THE SYSTEM WIL N 1 N SATISFACTORY. DATE..---•- .Z. v z� Inspector. E COMMONWEALTH OF MASSACHUSETTS BOARD F HEAVT ••-- .......... ....... Diupo �uorrku X_tzr% ton amit Permission is h b ranted---- I- /.... -------------------------•--.....------.......--•--.............-•-- Yg ; to Construct or,Rep ' ) a Individu T > o al....... at x---- --- No.--------•- Street as shown on the application for Disposal Works Construction Permit No"' ................ Dated�! ...... .:_✓. ........... ...................... --- ------------ -----------------•------...----•-•--•---•----......... Board of Health DATE................. a' ---•••••- FORM 1255 A. M. SULKIN, INC., BOSTON Y 1,& 137 LC A N �3d ( SEWAGE PERMIT NO. VILLAGE INSTA LLER'S NAME i ADDRESS ea? BUILDER OR OWNER D-A T E PERMIT ISSU DATE COMPLIANCE ISSUED - i i i rAe /y� LCAT N 3 ( SEWAGE PERMIT NO. VILLAGE INSTALLER'S NAME i ADDRESS e U I L D E R OR OWNER D-A T E PERMIT ISSY DATE COMPLIANCE ISSUED I f I r l y� Lov 46x,le M AP ,kA4P 16 'TU -1 WAY Q& 51 d, VBIA -Ij A ais A, oy 1 . e.4 -,--joy 1 � `/ `V , '�,. fir,, � � �_ i-� �•�j �� -_ .. �S^�\ ` � NN dl. 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