Loading...
HomeMy WebLinkAbout0659 SANTUIT-NEWTOWN ROAD - Health 659 SANTUIT NEWTOWN ROAD MARSTONS MILLS A= 029 -028 LOCATION r /T-Vt' SEWAGE PERMIT NO. VILLAGE INSTALLER'S NAME & ADDRESS B U Ill. D E R' ' ` OR OWNER DAT.E,- PERMIT ISSUED DATE COMPLIANCE ISSUED .F r W s h •7 \ is ter' , t f O pit No.-- F��... :3... 1............ 1.API THE COMMONWEALTH OF MASSACHUSETTS ✓ BOARD F HEAL H ......OF....... ... ... .. . ._. .......------ : :.. ... ,����ir�t��nt� •��x �i����tt! larks �tt,��ri� `irrt�Y� ,, Application is hereby made for a Permit to Construct ( ) orRepai-f ( Pan Individual Sewage Disposal System at: �- --�------�--� ------------------------------------ L o cation-Address -- Lot-No...----•-•----------------I—----••--�--- owner � •-•------_-•---•--.••--.Address Installer Address Q Type of Building Size Lot_---____________________--Sq. feet U Dwelling if No. of Bedrooms------------- -_ __ .Expansion Attic ( ) Garbage Grinder ( ) per, Other—Type of Building _______________________--- No. of persons_____--._-_--__.-.-_--.-- Showers ( ) — Cafeteria ( ) Q' Other fixtures ---------------------------------- WDesign Flow.........,,7.0---------------------------gallons per person per day. Total daily flow--------------------------------------------gallons. 9 Septic Tank Liquid capacity �!dgallons Length________________ Width................ Diameter----------------- Depth------------- xDisposal Trench—No_____________________ Width---------- _ Total Length-------------------- Total leaching area--------------._-___sq. ft. Seepage Pit No---------/--------- Diameter-_f-®d©__J� eph below inle ..... ......... 1 leaching area.._:_.___ 1... c It- Other Other Distribution box ( ) Dosing tank ( ) 0 ,5�c� Percolation Test Results - Performed by-----------------' ----------- .......................................... Date:------------------------ a Test Pit No. I................minutes per inch Depth of "lest Pit-------------------- Depth to ground water.-.___,/ ...... 44 Test Pit No. 2-----_----------minutes per inch Depth of Test Pit----------_--------- Depth to ground water-_.-_._-- _----.__.._ �+ -----------------11------------ .......- O Description of Soil----- � " � :� - ..--f•� } d = / e% - - 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 board of health. Sign. .. Date Application Approved By--------- -- �� Date Application Disapproved for t1T.e following reasons: - ------ -----------------------------------------------------------------------------• •----•-•---------------------------------------------------------------------------------- Date PermitNo.......................................................... Issued...... ------------- --- ----•r•=............. Date __ ♦ rt^ No.- FE� T.:HE COMMONWEALTH OF MASSACHUSETTSV BOARD F HEALTH OFr.. .. .. ................._.-.. . ir�a$ un firiutt1 lark Cntt #r�tr#ilattrrt�ti# R K Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at }' Loca�pn'-Address, or Lot No. 2 wner Address ------------ ----------- --•-•------••---•--••-------•--••-•---.......---.._..-••----------••---•--•---•••---------------- 'IN Install Address ^h Q Type of Building Size Lot----------------------------Sq. feet U Dwellingr1e No. of, Bedrooms--------- Expansion Attic Garbage Grinder aOther—Type of BuildingM__;__:_____________________ No. of persons------------------------:--- Showers ( ) — Cafeteria ( ) � ther rfistures . W Design Ffow.........,�"4o___________________________gallons per person per day. Total daily flow............................................gallons. WSeptic Tank-`Liquid capacity/wAo-gallons Length................ Width....._._-_... Diameter--------- ...... Depth---..----------- xDisposal Trench—No- ____________________ Width-------------------- Total Length-------------------- Total leaching area--------------------sq. ft. Seepage Pit No >_.._./____:____ Diameter.=/OAw_ ' � h below, inlet ____ _________ Total leaching leacchhing area------------------sq. ft. Z Other bution box Percolation rlTest Results ) Performed bytng tank--(-----)� ---�---,�C ------- Daatye------------`" ------ " ,aa Test Pit No. 1,_.__•_..__.____mtts utes per inch Depth of "lest Pit____________________ Depth to grq� d�water..__:� -_"".__---- rZ4 Test Pit No-`2_:�............minutes per inch Depth of Test Pit____________________ Depth to ground',water__._____--__-_..____.._. a ,• -___----- Description of Soil # ?, 7• /! — G U �; - -- ----- ------------------------------ ------- ,, -_4V A X�-w------- A- UNature of Repairs or Alterations—Answer when-applicable------------------_............................................................................. --=---------------------------------•-----------r--------Ain------------------- ......................................................... Agreement: i The undersigned agrees to install the aforedeseribed 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.,�een issued by the board-of health. l Sign pry' ''. "--- �`'��" Date Application Approved: BY / ,r --------`------ ------ �y .. / 7 r / . Date Application Disapproved for the following reasons:---------•-•---...--7_11_...;- -`-•--------------`------------------------•--------•-•-•--•--•------- a } *`" Date ..tty ay ._ •' r �r� •' Permit No.......................................................... Issued:- y, Date THE COMMONWE*L.TH OF MASSACHUSETTS • BOARD OrF� EALTH a 1..........OF............... ,�. ., .............................. ...... rr#tf irate a , ampffanre x : THIesta� CE TI ' he Individual Sewage Disposal System constructed ( or Repaired ( ) • byr= ---------•----•--••------------------------------------------- 1 Installer ----X41 has been ito ,accordance with the provisions of Artic XI of tate Sanitary Code as described in the application for Disposal Works.Construction Permit No.__-_ --: _:y '3 dated.... €j.���--��f....... ----••---•-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ; DATE............. --------•-------------•--_--- Inspector..................................................................................... THE COMMONWEALTH OF 'MASSACHUSETTS BOARD OF HEALTH C% ............................................ ...... ..:.......OF.........:. � :...................... No. __•-••--•- FEE__ tt1 rk Ltt r# ,aatrrt�ti# Permission is;'hereby granted._._.,_ ,...... ...................A..................... ........ ••• =-...-•---- to Construct o epair ,fin Indi l<dual Sewage Dispo,,za ystem at No .4 ;I - ,r. `........ jZgs'�,r91--- f - ' reet l� as shown on the application for Disposal Works Construction Per o.. ... J11_i__L/:_`_7f . 1 --- --•-•- - /- ate ,� ------------------------------- " Bo rd/o lth DATE... i_-: -7 ......................... ........................... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS i 4 PHONE 428-6236 CHARLES E. HAM LIN STEPHEN C. HAMBLIN BUILDERS K NEWTOWN ROAD SANTUIT, MASSACHUSETTS 02635 tf - 'Boo' �lln,oc-R rcfi.ovrvo �_ ,i ELrG?- i C:L. V i AND Land Qe r d 75 I ss' �n �- 100� LdfJ(1 't�oND D � �G Ft it �]CAWN. IS'r `JT�'r�WCnt L. 14Rr'+1r!, - 6+.00c i Sta3 f t IF"a.,ro CtA's'1 enl I 1 1 I f. y . 9 V µ,u /