Loading...
HomeMy WebLinkAbout0040 STEERE WAY - Health A C ASSESSOR'S MAA�P NO./ /40 PARCEL 363 z. LO CAT ION ' r SEWAGE PERMIT NO. t� VILLAGE 177 I0%` I'NST'A LIER'S NAME i ADDRESS s U 1 L D E R' OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED ems,. �►-pecks G.�t.. ` �-� � `'�� � :xS�R w_. 'I't 17,­ THE COMMONWEALTH OF MASSACHUSETTS �� _ BOARD OF HEALTH _ �.111 `.V.........OF......� t L� _.................. v Appliration for Disposal Works Tanotrudion Itprn it Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at• �. Lo /� Location-Address M or Lot No. ................_......._.....aJ2. r ................................................ ...................... `i ..--. ..............................».».».»--.. wner Address a ... •------•.................................... ::. ............... Installer Address �� Type of Building Size Lot_ �.;.._ ..Sq. feet ., Dwelling—No. of Bedrooms................(0.....................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Qa' Other fixtures ..-------••---••--•-•--••••-•-•.•-•--- "� --------------•...--.-..-..-..-....--••----------.------------------------.---.-------.-------- W Design Flow..............1 ....................gallons per pawm --r dad. Total daplyr i°w---.......__C .. ............ one WSeptic Tank—Liquid capacity_ gallons Length �.. Width.6.4..... Diameter................ Depth___.. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area.........._._ ..._.sq. ft. 3 Seepage Pit No..........'Z........... Diameter......L©....... Depth below inlet........4......... Total leaching area`�� ...sq. ft. z Other Distribution box ( Dosin tank( ) Percolation Test Results Performed by.-_ ..1'� :fj >:d*_ P., ' •--..----.- Date ....._.. Test Pit No. L.�.. ....minutes per inch Depth of Test Pit.... �__.__ Depth to ground water....AA..��//.``_�� 44 Test Pit No. 2._--..__-.Minutes per inch Depth of Test Pit.....1_ �.`... Depth to ground water..11.`.�✓_ V. .......... 4 ( �,--°.�..... 4---------- ------ --- oDescription of Soil .ES W -, -_Px -----------------------------------------------•---................................--------•-------.......----------•-......•.................. U ature of epa rs or Alterations—Answer when applicable............................................................................................... ..................................................•-----------------------.......---...--•-•-------•--.........---------------------.....------•------------••---..............•--.......---............ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of:I':L: 5 of the State Sanitary Code--The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee 'ssu d by thjhboarnhealth. / Signed._ 1 . .................... Date Application Approved By............. ..... D... .. Date Application Disapproved for the following reasons:...................................................................................... ..........».. ....-•---•----•--•----•--•--••-----•---•------...G..-•-•-------------•----.........--------.......------...........------.................---•-------........-----••--•--•--•----.......................... Permit No........... ................. Issued.............................. .............. Date....» Date E COMMONWEALTH OF MASSACHUSETTS - ) �,U TH BOARD OF HEALTH .- j ........ .. ..........OF..... �A to Appliratiun for Disposal Works. Tonstrurtion f rrmit Application is hereby made for a Permit to Construct) or Repair ( ) an Individual Sewage Disposal System at ................ : as�::�r:a, � _..... ..............T--..3... .. .................... Location:Address ^,y A _ or Lot No. ................_---•__.._•/t�(!3r•r,rt._: --•---••----------._•_..--•------ .._.....--------------! __... ..-- '..._._...----------._......... /Owner Address 94 Installer Address Type of Building Size Lot.'60.��_._r�..Sq. feet .� Dwelling—No. of Bedrooms...............!:' .....................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building No. of persons....................... Showers Wf� YP g --------•------•---••--•---- P ----- ( ) — Cafeteria ( ) Other fixtures -------••-•----..................... .fir?.. -----------------------------------•--- ...... Design Flow.............�.� ...............___..gallons per p n r d(}y. Total d ilyttflow............� ..4?........__.._gallons, W Septic Tank—Liquid capacity�.�' Mons Length p..o... Width_C5,.4..... Diameter................ Depth... epth r.. x Disposal Trench—No..................... Width �......._...... Total Length..................... Total leaching area.__.._..•..''..jj._....sq. ft. 3 Seepage Pit No..................... Diameter.....-._._.......... Depth below inlet.......G-------- Total leaching area.��...#_."._.sq. ft. Z Other Distribution box (� Dosing to ( ) r Percolation Test Results Performed by �.� -* !� -•.P. " Date y�`�9 -�- ..--....... p 1 Test Pit No. L�.�._minutes per inch Depth of Test Pit...�.4�n...... Depth to ground water... .. . w 44 Test Pit No. 2.........�rilinutes per inch Depth of Test Pit.....1 .... Depth to ground water..:---.U__.._: a 1 tI _ O Description of Soil.......".._ _ � + -- ►�-�f'�� S l xF�q,rcy........... --------•- ----------------------•----...------... ---•------------- -.-----------------------------•---- ---------••---------- 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 .I.LE 5 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 boar•Hof health. ,�/ ., t - 0 .Signed. tea% .._.....----••.r... .v. ....,.... t :. ,.. �.. Date Application Approved By--•--•-••---_ ... _......v:_..._.. ---------7-- me--.. � Application Disapproved for the following reasons:..............................•--•-•--••----------•••......................z.............................. ..................................................•............................................................................................................................... ...................... Permit No........... .................. Issued.._.____- _ ..................... ...au...... Date -----.srw..r.----w...n�<r..,+,..•+r.._r.:.s?s sw. .Ma�.i..+f'M'-ts-r,-�.'.a. w....e.�:..z-...+.v-: .-r . ��_ _ THE COMMONWEALTH OF MASSACHUSETTS -- -- BOARD OFF HEALTH �,�{ ............r./...........1 4.......OF...............!..r>`:C '1:'"` XX/ .......................... Trrtifutttr of Toutpliattrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (>) or Repaired ( ) by................•• .... r ... ----•---•-•--- ---•-•-•-------.........._........... ......................-----..........----.........-•---- Installer has been installed in accordance with the provisions(of TITLE 5 of Th State Sanitary Code as described in the � — .3C� �application for Disposal Works Construction Permit No............:................. ......... dated..........._...-....-_.__........_......_..... THE,ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM"WILL FUNCTION SATISFACTORY. _ DATE............ >s .. Inspector.. THE COMMONWEALTH�OF MASSACHUSETTS BOARD OF- HEALTH No... .... 1.....3 Fes........................ Disposal Works T'unutrttr#iun rrrmit Permission is hereby granted...........R"`=--:�-`....--. �-=? +_6-------•-•--••...........................••---................---•-••---•-•--- to Construct ('>c) or Repair ( ) an Individual Sewage Disposal System t�r� ' (lee n . . at No............................................ - _ -....._.. ........ •-----•--•---•--•-----•-----...-•-••••-•-•--•----......... Street �[, / as shown on the application for Disposal Works Construction �mit No.�2._`�� Deed._...�...................n.'?..... DATE_ , j. � Isgard of Ileauh � .O61/ . .. . ...... Imo' ICS © O r• 'PI-TC oT"eewtsE ti 0TF-P, - ►&,a LO&MtlC a.i�+�e�c�.sT U►�l1TS a rho -� 44. 5. P t FL Jo I r.LTs M 40E I ►a'rE 2'R ls'+t7 \ . 'I Ca' cotlsTRUG7iol•l DETa1.6 To BE ►�.l p�o�GD4tirx' �: Tr ` t \ t "1 .Ti�15 Yc Arl C OsEo Woel� o►l t_y dND h �1 I•D t ic7 ` t r T. . S- ^y. a Lit y Jv L `'• - 1`�., - �+ — v�p/fStz - �•(ct' G.PD iF ,�}� _ r Rc ' �, \ l;C \ �� \ `' ` "e� _� w �t'�rlX Nk `0 Jam. 9.._�� � C�-d�Lr�r.l T�►.�k y. � .- `-1.Ci- L �4 o K- � � l ( �• � .. 7 t `(� ,,� ,� �S ,- s r ;��e�, C `- �/ � ``7L" _ �� iel �' f'rA1 '�t-�T r-:� � � -- + �\ P�.1��M' - �'1 (: j = 'S�, _ �ITE s►�c �.�1 .1��E r-',�,r`1 ----------- ALL 9;:2 +r,� '?QEP E � Al ncrrinp inG t ci.-.� N - doWf7 eaPG Cn9i ! ►n. a_rez ; ,; aj4LA ov 4f.AL.Tf ' L.&I'to su EYoeS IZ7E -(oeM0UT9 M oSs 4 . 03A