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Home My WebLink About0193 SCHOOL STREET - Health f 193 School S t: c ^� Marstons Mills ,1 ALO, C„ � ION , � SEWAGE PERMIT . NQ. �jx'a, . VILLAGE tz INSTALLER'S _ NAME .,,'. ADDRESS N/ R OR. OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED •- �a i r l Fss.....�.�................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ....................... ...............O F..........................................------------------.............................. Apptiraa#ion for Uhipvii al Works Tomo rnrtion Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ...� ..................... ..---.-•-------•-.-•--------------•---. ---- --------•------------•-------.----.--......... L a§ion-Addres or Lot No. .__.:.... ............................. ..................................... .............................................. ....--- �j 14 14 [. Installer Address V Type of Building Size Lot...�_'l_�jh!M.._._Sq. feet Dwelling No. of Bedrooms____________________________________________Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons............................ Showers — Cafeteria P4 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_IQ:..«?._.'_ 7._..... aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Lz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a .-- 0 Description of Soil-- - Y4_ j._... V --••--------------------- •-------------------------- •----------•-----------------•------------ -------------- ------- •---------------- •-------------------------- ------------------- --------------- W --•---------------------•---------------------------•-------------------------------•--•-----••----- V Nature of Repairs A eratio s—Answer when applicable__ :_.. _ _ . _"' ' -eel 0 Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TI L 1Z 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is ued by the board of health. ke-10 Si ned. 10"!6..... ' Date Application Approved By.................................................................................................. .................... -••---.............. Date Application Disapproved for the following reasons---------------------------------•---•----------------------------------------------------------------........._ ----------•---••----•------------------------•--...--------------------------------------.............---I•------------•----•--•-•-•---•---------------••----------•-•-•-----•----•--•-•---•-•-•......... Permit No....... .. ... ., .................... - - . Issued .......: ` A D -ate' l_ FnB............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................. ........................OF........................................................................ AVVIlration for Dhiposal Works Toustrurtion rantit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: M--------------.......... . .... .................................................................................................. cation-,AddZre or Lot No. ..............e.. . , ... ............ .. . .............................. .................................................................................................. V Address Installer . ............. .................. . ...........I........................ Type of Building Size Lot.40.-.,A_0-q- -------Sq. feet Dwelling No. of Bedrooms............................................Expansion Attic �;�?Qe rinder Other—Type of Building _............................ No. of person"s............................ Showers ,,i Cafeteria Otherfixtures ....................................................................................................................................................... Design Flow............................................gallons per person per day. Total daily flow... .1................gallons. 9 Septic Tank—Liquid capacity............gallons Length________________ Width__..__._.__.____ Diameter..._..___. Depth_____.____...... Disposal Trench No_ .................... Width_____..-._..-_____._ Total Length._._._______._._.___ Total leaching are I a....................sq. ft. Seepage Pit No..................... Diameter.___..__.___._-_._._ Depth below inlet____.___.____._..__. Total leaching area..................sq. f t. Other Distribution.box Dosing tank Percolation Test Results -Performed by------................................................................... Datw.o........./.......6..�....... Test Pit No. I................minutes per inch Depth of Test Pit.___.________.______ Depth to ground i water_..____________________. Gi, - Test Pit No. 2................minutes 'Per inch, Depth of'Test Pit.................... Depth to groundl\water.................. -------------j-------- .................................................................. 0 Descriptionof Soil.,-e�-_-� -t- ,.... ......... ...............................---------------------------......................................................... ----------------------------------------------------------------------------------------------------------------------------- -------------------*-------------------------------------------------- --------------------------------------------------------------------- ....................................... ......./........................ _--ti-ops ------ *-------------------- U Nature f R airsjor -Vtera An"sWer when applicable -------------47....0...1.0------ ......... r ................................. . . ... . ........................................................................... ...... .................................... Agreement: The undersigned agrees to install the aforedescribeP Individual Sewage Disposal--System in accordance with the'provisions of T I T 1E 5 of the State Sanitary Code—The undersigned further agfees_not to place the system in operation until a Certificate of Compliance has been i5sued bF the�boar o health. 17ra Sign 70 T Date Application Approved By ....... ............................................. . .............................................. ........................................ Date Application Disapproved for the following reasons:..........................I...................................................................................... ................................................................................................................................. ....................................................................... Date Permit No.......< -.q .... ...I--------------------- Issue4e_4............Date......... ..................... THE COMMONWEALTH OF MASSACHUSETTS BOARD 'OF HEALTH ..........................................OF.:*-* .............. .......... TntifirW of Toutphatta THIS IS TO CERTIFY, Th the* Individu al Sewage Disposal System constructed or Repaired by---------------------------------......... ........................................................................................................ te Ins'�Uer at............... .. .. ..............4k . ...... ............................................................................. --------------------- has been installed m accordance ith the provision�'of T17LEF 5 of The State Sanitary qode a d d the application for Disposal Works Construction Permit�No.. -------------- datedl- -1jj ........ THE ISSUANCE PF THIS CERTIFICATE SHALL.NOT BE CON TRUED AS A A THE SYSTEM WILL F N UTIS CTORY._.ION4 DATE.................. ...0. ............................ ^;, .....9._p r........ ........................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................................OF...........................................I..,..................................... ......... FEE %Vosat 10o rks Tonstrudion "prrutit Permission is hereby granted —----- --------------------------------------------------------------------------------------------------------------------- ) �4 Disposal System to Construct or.Repair ( ....an i"iu ewage at No. ;,,ec^ ;>------------ --------.. .7. ----- --- wi------------------------------------------------------------- �-7 Sire as shown on the application for Disposal Works Construction Permit No_____________________ Dated..____.________.______.__.______._.....__. --------- ----------------------------Board-of-- ---- Health----------------------------------------— DATE.....-•-•--•-•--••-•-•----•----•----•---------------------------------•------- FORM 1255 A. M. SULKIN, INC., BOSTON LOCATION / SEWAGE PERMIT . NO. VILLAGE u//WaoL l INSTA LLER'S NA E a. ADDRESS r R 'OR OWNER r DATE P_ ERMUT ISSUED DATE C0MP`LIANC.E ISSUED i 14 i .. 11 _-