HomeMy WebLinkAbout0063 SPUR LANE - Health �.� S�� 1� t����
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LO-CATION SEWAGE PERMIT NO.
VILLAGE
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INSTA LLER'S NAME & ADDRESS
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B U I'L DE R OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
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No. 21 Fps ..:1
' THE COMMONWEALTH OF MASSACHUSETTS 3_
BOARD OF. HEALTH �- -
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.��r��ir�#inn �fnr��in�runttl nx�n Cnnnn#��tr#ins �rxnti#
Application is hereby made for a Permit to Construct (,//) or Repair ( ) an Individual Sewage Disposal
System at: /
�Iiyi�,�°jr! .s.7"a.✓c ST S...................... ho.T_...`.....------------..............................
Location-Address or Lot No.
$ f}SN C ® ° Puy u2�% S�./C= / �7�e n1p fit'j'°'! 0= /`/A�2SNr�tG�
ner Address
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--- ------ ---- - -------------------•-•-
Insta r Address oZ7ba q
d Type of Buildin Size Lot......,... .................S feet
Dwelling 2No. of Bedrooms-------t;----------------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ---------------------------- No. of persons.--_-_.----.-_-_------_--_ Showers ( ) — Cafeteria ( )
P4 Other fixtures ----------------------------------------------------
W Design Flow....._. ........................gallons per person per day. Total daily flow....:.3oq............................gallons.
WSeptic Tank—Liquid capacity16_0_0__gallons Length................ Width--------.------- Diameter------..--.----- Depth.-..---_-
xDisposal'Trench—No..................... Width--.--- -_-_-.------- Total Length--./--_.r.......--.. Total leaching area.....--..--..-.-:._-sq. ft.
Seepage Pit No...... of
Diameter__-.Q._..--- Depth below inlet�z.�0---_----. Total leaching areaZ�--------sq. ft.
Z Other Distribution box (✓) Dosin tank
'-' Percolation Test Results Performed by -T-.rz-_ C_�� .Ql✓t-....- p -___.--..... Date--4Z_-KP 4_./_l23-
aOBS +est Pit No. 1................minutes per inch Depth of Test Pit�Q_-.2....... Depth to ground water.�o �--..-----
�, Test Pit No. 2.... .__--.--minutes per inch Depth of Test Pit------.d.----. Depth to ground water------------------------
- . =
;-- --------------- ------------------..-------------------•-••-•--------------------••----•--.•......................................
7 - 97.00 Description of Soil-- ------ --- ..- ---- ._ :
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,--aR
......$A"Y-D•----------------------------------- ------ ass
yN
G.
;j j Ka ti-------------- - -.-------- aver when applicable y
Nature of Re--airs or Alter --• ......................^ .._. _' ` .
------------------------
Agreement: 'o'.cs
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in acc
the provisions of Article \I of the State Sanitary Code—The undersigned further agrees not to place the ystem i
operation until a Certificate of Compliance has bee by the board •f health. 7(11
--------••-•---Signed-.. ...•. Date
-
ApplicationApproved BY-----------------------------------------------------------..........•---------------------------- .........................................D
Date
Application Disapproved for the following reasons------------ -----------------------•--•-------...---------------------..-.....-...-..--------•-----------------
.....................•---••----------••---•--------... --------------------------------•-•-----------•---...--------•----•--••-------•-••-------------.......--•-------------------------------------•---
Date
PermitNo......................................................... Issued........................................................
Date
.2-
NO......................... Fnic
.. ..............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.... ................0 ................................................
Appliration -for Btgposat Works Tomitrurtion Permit
Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal
System at:
/V I-VI H 6 5-77) V Z4 7X s O'g,
..........
........................................................................... --------------------------- ................................................
Location-Address or Lot No.
P................... 2....... ........ ............ F. ..................................................
- ----------------------------------
net Address
................. zf?l..... PeA
a e Addr Inst r ess11 Type of Building Size Lot_��/'/__30P----------Sq. feet
U
Dwelling!7No. of Bedrooms------- ..................................Expansion Attic Garbage Grinder ( )
Other—Type of Building ------------------------ ... No. of persons._......................... Showers Cafeteria ( )
PL4Other fixtures ----------------:------------------------------------ ---------------------------------------------------------------------------------------------
<(I
W Design Flow-./----------5--P------------------------gallons per person per day. Total daily flow-------12*?----------------------------gallons.
9 Septic Tank—Liquid capacitv�0�9---gallons Length________________ Width_..----.._.__.. Diameter_-_------_----_ Depth----------------
Disposal Trench—No No. ------------------- Width-------------------- Total Length_-_.-_ _--__;i-_--- Total leaching area.-------------------sq. f t.
Seepage Pit No------I.......... DiameterB.'-s........ Depth below Total leaching areah�--------sq. f t.
Z Other Distribution box (/) Dosing tank ( )
Percolation Test Results Performed by.K0A,3.r... .....RR ........... Date... Ar-je,l- 4_73
------------------------------------
0/-15 +est Pit No. I................minutes per inch Depth of Test ....... Depth to ground water_�&�(4� -------
LL, Test Pit No. 2----!9'.........minutes per inch Depth of Test ------ Depth to ground waten. --------
Ix ----------------- ..................................................................................................................1,q_f0)F.
0 Description of Soil__ ------- . ...... — ;F40.... ..........---------------------------------------------------------
Ear
----------- ----- ------ ------ ..................................................... .V f R
----------
Z_/- ------- -
-,Tb 6 AACCLOM'
--------------------------------------------------------- ..............1 - -------
U Nature of Repairs or Alterations—Answer when applicable.-.-_-_----------- ---------_------------------- ......... ---- ----------------- -----
----------------------------------------------------------------------------- ----------------------------------------------------------------------------------------
Agreement: ECG
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in a
NAL
ith
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.
Signed...................................................................................... --------------------------------
Date
ApplicationApproved By................................................................................................... ......................I-----------------
Date
Application Disapproved for the following reasons:----------------------------------------------------------------------------------------------------------------
Da t e
PermitNo......................................................... Issued---------------------------------......................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..V........................OF.... /34'4;"*** .........
tv ..........*............Qwrtif irate of ("'Tom pliaurr
THIS IS-TO RTI Y, That the Iaaiyidna Sewa Disp s J System constructed or Repaired
by ------------------- ... ... . ......... .............. Ar j+ ... ..........................................................
In Zer-)
at.....e�L�!--------3(--------------------------?"2���e--!-I e14, FS7-47-F.5
.....................;�----------------------- ---------------------------------------------------------------------
has been installed in accordance with the provisions of , r�i 4,ge State Sanitarysc ibed.-m,the
application for Disposal Works Construction Permit No----------------------------------------- dated /�7-4.-ZC.................... ...............•. -------
T&�n_t?
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE-----------//................/..& .......—4,1� .......... inspector----------- -------- -
.....................
THE COMMONWEALTH OF MASSACHUSET
7 BOARD OF HEALTH
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C .... .. .... .. .............................. .....
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................................................ ...................
............(
I IVnrk Qlangtr rtion Vrrmit
hereby gra.nte�... -------------- ...............................................................Permission .........%_,
to Construgt or Repair an Individual Sewage D* oval System
—( �)s I Z
at No.__AZ7..........?4...........
.... --------------------------
------------------------------------------- -----------------------------------------
as shown on the a $,treet 2
application for Disposal Works Construction �jWit N11. Dated----71 - 7,1,
-All� ------------------_----
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.... . .. . ... .... ......... ------------------------------
...X1. r?_�
Board of Health
DATE_-------------••------•------_.----------------------------------------------- 7
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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