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Home My WebLink About1895 SANTUIT-NEWTOWN ROAD - Health \ 61 rS 1 ` n:s� < L S LO CATION TuIT SEWAGE PERMIT NO. t VILLAGE INSTA LLER'S NAME i DDRESS MIS ' R U I L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED ION G-ht. s 6cy , fC)f tOCOCA L. Fee-f`+l C.-r PIT No � 2_ Fs$...�s�......®..• . w� THE COMMONWEALTH.OF MASSACHUSETTS BOARD �OJF -�I—I ALTH .. 0 .................OF,•..,.' S..l'l� • AppUration• for Uiipuiitt1 Vorkii Tonstrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System a� ..-�. ...........................c�...:................................ . ---.-��'�------. ---- --.---..-.-----:.----..-.--.-- or ......�ZV.._...... ati�n..Address..................................: . .•`7.Y T�. .....................--....--•-- Iddresw a .................................. ...........M m... u!.73. . 21. ----------------------....---------...--------•---------. Installer Address Type of Building Size Lot.__'� ? ..:.....Sq. feet Dwelling—No. of Bedrooms.............C�........................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building .. No. of persons............................ Showers — Cafeteria W Other fixtures...........................•---. . -- ._...- ---•------------•--------------------------------- Design Flow......_...... ......:................gallons per person per day. Total dail ow.._...-__��..0----------_.._....._._.___gallons. WSeptic Tank—Liquid capacity/...gallons Lengtli__&S__._.__.:.. Width....---..... Diameter________________ Depth.5.._4 .__-. x Disposal Trench—No..................... Width.-i................ Total Length........ j_.._._..Total leaching area....................sq. ft. Seepage Pit No..._.....L.......... Diameter..../!�....... :.__ Depth below inlet...... °....._..._. Total leaching area60........sq. ft. Z Other Distribution box ( ) Dosing tank ) '~ Percolation Test Results Performed by.......... ....... :..............................-..... Date.....7/V1 ............. t'• Test Pit No. 1..... a-.....minutes per inch Depth of Test Pit....l60-...... Depth to ground water........................ G Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' /'!� 0 Description of Soil...Q.."/0_'..... o�?_°`._S S_...S9..S ....-----«----- QW91.----------��2 . ............lG .... If 5to4 . -•--•----------------------------•--.......-------------•-•-•-----------•------------------•--......------------------....--------...---....------•--•-- 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 TITLE. 5 of the State Sanitary de—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b n sued y o health. Signed.. ..... .............................--- D e ; Application Approved By..--.----- ------------ ............. ................................ •-•------- --------- .fi t ----------- Date Application Disapproved for the following reasons----------------------------•----------------•---•---•-----------------------•---------------------•--••-----.._ --•-•-.........--•.............•-•-•------•--•--.....----------•--------•-•---------------------------------------------•-----------•------------------•-•---•---•-----------------------------......--- Date 2 Permit No.----- ! 1 •-•---•--.....- -•-era------------------------ Issued....----- ... =--- •-�.....----------- Date L No......St.-_'15'2... Fss... e' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............. ..........................OF...................................-...---------------..__......_._.._-._...............-- Appliration for UiopooFal Works Tonotrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................---.............................................................................. ......-----------------..............--------•-...._..--•-------------.................----....... Location-Address or Lot No. ......................_..--...................................................................... ..........--...................................................................................... owner Address W Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of-Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building No. of persons............................ Showers — Cafeteria a' 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. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (X, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1:4 ------------••-•--•-•••----•-........•--....•-•------------•--------------------•-----------... .--- ------------------------------------------------------ 0 Description of Soil........................................................................................................................................................................ x V ---------------------------------------------•----•••-----•-•••--•-•-•----.......---------•--••-------------•---•--•-----------------------•••----------------••--•--•-------•-•----•-------•------..... W Z. 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 TIT E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has e issued b e_bard f hea Signed- _...._ ? Date Application Approved B ... ................ o .. ................ ----••------------•--•---------••------•....................................Date Application Disapproved for the following reasons______________ .__.._.._..._ .........................=.................................................................................................................................-----------................................. DatePermit No...... .. .. ..................... Issued..-----1 -..�-•--- '.? Date 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF................... ,... . ............................. ....... (9rdifiratr of ToutpliFatta THIS 1 TO CERTIFY T t the Individua Se)vage Disposal System constructed ( ' or Repaired ( ) by------------------ ................ .... ...............................................................................................Ins alley at. l f� = �` ...._�....�..---•��..... -' -----------------------------•---...............__....-•----------------------•--••-------------•. has been installed in accordance with the provisions of TITLE, 5 of The State Sanitary Co e as d cribed in the r application for Disposal Works Construction Permit No.__� .7-Q _-�............. dated---LQ__.r�. _ _._.._..._._._... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A G ARA EE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............. ' . . -...... .......................... Inspector....... C&4.................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �,� ....................OF.......... ...-•---......... ............................................. NO...... ....... .. FEE................:....... UiopooFal orko �ono#r{nri�on�l� erntt Permission is hereby granted......'1" .. t_...--•- -0 4 } +:&�`............................................................._.... to Construct ( ) or Repair ( ) an Individua Sewage'Disposal System at No............a.....4J6L &i,..... 16�-----....w(11I Street ; ��—:q�" - i as shown on the application for Disposal Works Construction Permit No..... .i ............... hated..__..... Lt,?_. �__................ ----------------------------- ...------------•------------•---- DATE_ �.. � !_- Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS L /00•5 II 95.2 95.0 10 0 o i'ST. g� WaS�tcc� S�v//e� 96.0 a eno Co Fr.Dt�Nt. I Dp0 �, �c 954 A o Go►1c• LEAcN►u� P,r Se-p+rc- TaK k 95 2 a 4a d AAA G a r 44 2 F A Bor• PsT EL-P-ti/ _TEST ptTS DES 16IN DATA: 9.a D`D Gg-ouuD PER.00 N RATS. 2 11)JCJ.� C)P- P 7-oI CLAY -fO . ,-,3t Q0-PROOMS K 110 GPD = 330 C Pp LEAr-"I ,1G, CARBACzE DISPosAL USE /000 GAL•SEPrl(-T/1.JL A PE Rc.l? 95.9 CA PAC ITy PR—0V19EJD ' Spar. -BaT7-01,4 Tr (5.0)'x 1.0 = 7,9.54 Cp p St 0E5 27 ' xs•0A4.0K2.5 471•24 C PP r�4. I OTA-L CARAC ITy F 0vl Dap 5749.76 C pD �UC.rovHd (,�a�er�nCdud�r��1 �voT� — Dc5POaiL S�1s1�1�► D�s1C�►JED 1 /� /7 QcLoRD^"Ce w 1 T44 PP OVISIONS O.F T'1Ti-E S o� T/-�� luj�SS . �=-Nv I�ULJ�fEwTAI_ G c> LO Z C0 71e 7— jolL 5TRArA S�4L_:ET Z !! LLY- Al � r f7c,.P,aE 4•souu - wA .PV.C, < 44 Yr Ri ' .. ! .. _� ..err..G�"�' Y. •�t z' .. '' . ,� 1. F �E . - - 1 I Y .itt � r�� • ' .. i�Y.M � �_'. f -� S ' � '` - � - t . � ` �' • �• -Ttr• = • •Y Y.. _`� I��//y I •� • - t .. are � ` Caner VI Zio- EASEMEM Ire 3�� - . ,_`' _ay•= ] •• - - -` _. ,r ,� •' REGISTERED ,�� y� CIVIL,�ENGIN aa= r • �,� r � ,�� • . - _.. • ,. � • - OF 44, r WALTER r t STA$L: ,MASS E. h p y SMITH;.JR #15128 P ,� FssIONAI:E�G� - um i4vio MASS, SC , I"= KY! /{ /•�j,.y S.If• i,' 110. 4 • -F'. .- . r . ,� •Vh *• � -.. c,P ,• + . ,• . t�`�iW Ti/1y1 •• sT � , , _ Y ,C. I