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0062 SAWMILL ROAD - Health
-0 Lj LOCATION 5EW6,6,E PERMIT k10. -3 7�P) VILLAGE BUILDER.5 Q &MF- IN,DDRE SS DATE PERMIT ISSUED D ATE COMPLI &MCE ISSUED : 3_ __.._..�._...____—._______.. ..,._,._ __._._.____._ _e,._....._._._.________� � ,� � �� __ ....�� \� � yE �'� � � R� iv / � ., . . r _4 No ..........`......... F��../..�.. ...... THE COMMONWEALTH OF MASSACHUSETTS N�d � oF.. . � �� .......................... Appli-ration for Miyartal Morks Toni Linn Vrrmit Application is hereby made for a Permit to Construct (Vr or Repair ( ) an Individual Sewage Disposal Syst at• atio - ' e .. - � A/ - .4 .. �W.�;� � ............. . :UAdress ..... -! oc --------------•-------•-------- AFot No ' . ........................................... Owner ddrs --------------------------------------------- ........ •--------------------------.--..--..-.----- Installer Addres _ ._ s Q Type of Building Size Lot_ Sq. fee aDwelling—No. of Bedrooms___�__+.��F'r_.:4.._..................Expansion Attic (� r Garbage in der o, p, Other—Type of Building .:......................... No. of persons-------..................... Showers ( ) — Cafeteria ( ) Q' Other fixtures --------------- ---------------- - W Design Flow.....57-C...............................gallons per person per day. Total daily flow..._3P.-dafs__,r `...__gallons. W Septic Tank—Liquid capacity.lptV..gallons Length................ Width................ Diameter................ Depth............... - x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..4�' ./Diameter------�z_._____.. Depth belo°,inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (�� Dosin tank ( ) J N- `3 7J`� '—' Percolation Test Results Performed inc�'De Depth Test Pit___________________ Depth to Dround water� �_______.__.. a Test Pit No. 1................ t l p p g Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a .......................� •. �. • -------------•------ � --•---•......................................................... O � � ' =�.p�escriptionoo ------ � ' �� �. .............-•--...--- x / 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 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 ' by tke b9arj oealth. jgn•dd... '. r -------------•---------- -=�=---��----- Date Application Approved By...�% - • .........L.-+ ��:A - Application Disapproved for the following reasons_____________________� Date _.._... •---------------------------------•--..................._ ------........ •---•---••-•-•--•-•------•-----•................•---•--•--------------•----------------...............--------••••---....----•-••-----------•--...-•••••-•-...•--•-...........-------•------------------ Date PermitNo......................................................... Issued....................................................... Date - No......�:�......... FnE..&�........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - � 7- '� � oF.... i-y��/ X — ----------------- Appliration for Dzfivo. ial Works "Wratdton Prrmtit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: p ...... - ' • ---------------------------------------- ..._.. --._....... o hon-Address C r Lot 4y..... '� + t.........................••--•- f." _ !_e.0 .�aLf�.... �d 5......... ......... W Owner �• A S ............................................ ........�!__ _!�'�:a5"c�lFt�.��i..._����•raj/��.._._._..__...__._...................__. Installer Address Q Type of Building Size Lot............................Sq.�fe�t U Dwelling—No. of Bedrooms_______________1.v�...._..._......Expansion Attic (/ Garbage Grinder 915 iv aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ..--•--------------------------------------------------•-------•--•-•-•-•--------•----•------•--.................................................... W Design Flow......40................................gallons per person per day. Total daily flow-..,P_V ?/rd_r�...-a°:Z.%......gallons. Septic Tank—Liquid capacity............gallons Length------------_- Width................ Diameter---------------- Depth................ W 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 ( d, •6 "3-7$- /0 C '-' Percolation Test Results Performed by.6y" __ia.... Test Pit No. 1................minutes per inch Depth of Test Pitt_...._._..._.._._ Depth to ground water........................ Pq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' ----•---------------------•---•-------•-------•---•••-•------••-•---•--......----•---------•...-----......................................................... ODescription of Soil........................................................................................................................................................................ 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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee ed the b ar of health. c �ig d _ �_------•------_----- r' ? Dad Application Approved By..�'" / Y 'f '' " -6. -- .....---- .......................... Date Application Disapproved for the following reasons--------------------- -----•---------------------------------••------------••---------------------------_----- ..................................•---•----------•-----•-----......-----•--•-•--•--•----•----•--•- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH 71 ................OF.... ... .................... .................................................. (Irdiftrat a of Tontplianrr THLS TOG n, Y 7 at the Individual Sewage Disposal System constructed (�or Repaired ( ) bye (._.. a .,,.(ti'........................ - -- -- -------------•--......._............--•-•-•-•-----...----..........--•----------•--......---••---.<.. Ins ller v ;...........•-------------------------------.._..._--------------.---------------------------- has been installed in accordance with the provisions of Ar�c X�o The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated_...`......_______....� 40 ......__._._..._._.._. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS f 1 BOARD Off HEALT ! c�•'r..r/►`1:..............OF.......... `.-'` .. . . t d No......................... FEE........................ MOV0.0al or ttr#ion Prrmttt Permission ' ..hereby granted.......(. T/Y -i ....._ to Construct ) or Repair ( ) an(Individual Sew g ibis os�al�§ystem _ r. -------- ------------•------•----••--•--------•-•-----------------•------_.... at No - � Street as shown on the application for Disposal Works Construction Per No._. _........._YI Dated....Ili.......z j�........... DATE.......................................................................................................•----..................._..._.......... Board of Health < FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS r'�� IVt A.�e�--ram L,�•M+�•.e+� .__ .. _ ____ _ —_. � ^VI ��i,���Loa. .., ��.�v. 3`7.."s• � Ella}}1 _; ���� � a.,-,. ►,a.c..�-....n... ...t _ ._.. _ __.._.__-- � .■fie 0• .�� , � -' — i a, CeWN i J e 1� F ^Je F�P=• •� �sa-�+- ems...-�v.-�d` �/. �'� �o T� - �7Z1 Gr-�+•. r-ra.� � i I i t I I r. t A., :..'-•cF. �, t'-�`1 L� �7■e.vrlCar�r✓1 l_r.J rrt .�prtr-crri I y' `i .!o T�V ` © I I�1 �i I i s,r�cJ w 6 s✓��-r+q t 16.r-.�rr r �\ . f 0 l 1 c., �A -J �a w r"+t L- Q v bc;;, M►tea.�, ®►J•. t�l ti M�. . ONAWN my T- DATt AM'RO'V[D BY I DAAWING MUNSON l...Q ra■■■to aa� s■■.