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Home My WebLink About0156 TROTTERS LANE - HealthF15T tters LaneMarMills A 032 011 - -- i r / C i O' ,ap,ECYC(ir�c oq Z UPC 10271 ' No. H163Y HASTINGS. UN 7q_ ?� ,LOCATION l� SEWAGE PERMIT NO. ` VILLAGE I N S T A LLER'S NAME & ADDRESS X,' c-Y a .c, ; c- /C S UILDER OR 13 DATE PERMIT ISSUED DATE COMPLIANCE ISSUED :_ / � b �� s ��'��- G1'� �_, i � " !JC'��(vorn �s7 ,% /�� (�� 70 �� r ,�", `` � �� e �� No.._.......•._.....�....... -"* Fizz.. . THE COMMONWEALTH OF MASSACHUSETTS •' "y BOARD OF HEALTH `� v I -_�.. ..................OF........4s.R•.....�'�._ N' 03 1 ... ................... .�pplirFation for lliipnsat Works Tonstrnr#inn ramit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: # ...: vs -- ................... -----------L®-�--------...�®-----------.........-----------......_...... �7 Location- ddress or Lot;To. W '�,! R O si �-� 4/oa 1�o C : . 110.1............ ------------------------------------------- - . ........._......_...............-------...... . Owner Address o {---------•--------------- ... .................... Ins r ess „� Type of Building SiAdze�i Lot.2 l^..? ...Sq. feet U Dwelling=No. of Bedrooms._...._.. .....Expansion Attic age Grinder( ) Garb ( )�+ — '� Other—T e of Building No. of persons............................ Showers a YP g -------------------------•-- P ( ) Cafeteria ( ) dOther fixtures -----•---------------------------------------------------------------------------------------•----•--.....---------•-----.........-----......--.--•_.. W Design Flow............................................gallons per person pyr day. Total daily flow__._...._...........................__._....gallon WSeptic Tank—Liquid capacity............gallons Length.7..Y.'. Width.e/.-t"O.--_ Diameter................ Depth..e,_',_�_.. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........./.......... Diameter..........6....... Depth below inlet.....6............ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) / aPercolation Test Results Performed by.......A_ �.._.. U r k�s......................... Date.... ,/_7_ ._._._. rr- � Test Pit No. I................minutes per inch Depth of Test Pit...r®_........... Depth to ground water-.N�...�®. Lz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ .......`'..._.q�/•v i7iS 0 ...............O .. ... .......................................... Description of Soil..................5-./`..........4.-..e 4."Losl................ ........ ......�- ..r Q j......--------..... 9 A.k,,-,t-..4................... W -•••------------------------••-••••--------••-----•-•--••-------•----•--•-•-•••••••-------••-•--••. r7. ...........................- i �` V Nature of Repairs or Alterations—Answer when applicable. /�G�! -.- ....... .................... --------------------------•-•--------------•-------------------------------......-------•-•--........---•---•-------------------------------•--•--------------------------....-••-•---•-.._.._••---..... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT 1E 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 board of health. Sign ____ Date Application Approved By-- .. - -�644 --,.................... -•-- - ' Date Application Disapproved for the following reasons--------------••••-• --•---•--------------•-•---•-•••---•---•---•-••••---•-•••-•---•-•-......••-•-•----..._------ •---••--...-•.................••••--•---------•-•--••----••-------------•--•--•---•----•---•-•-----------••-•-•--------------••-----•-----•............................................................ Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS ' BOARD jO HEALT ........ . .........OF........ ................ Qlatifiratr of Tomph anrr IS IS T) CE IFY, ThQt th , ndividual Sewage Disposal System constructed orRepaired ( ) by.. = ........... Install . -aw has been. installed in-accordancewV the provisions of T of The State Sanitary Coe as described in the application for Disposal Works Construction Permit No... ��....�.7a............. dated-... n7l,_._----•--.--.---. THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ` DATE................................................................................ Inspector.................................................................................... No... ......... ....... } THE; COMMONWEALTH OF MASSACHUSETTS OARO OF HEALTH 10 --- Applirtt#ion.for Dispuuttl arks Toostru.rfm rumit Application is hereby made for a Permit to Construct' ( ) or Repair` ( ) an Individual Sewage Disposal System at ................•••--•-•••...................----- ......................_•-•-.._.._____...._ ....................................................-•.............................................. Location-Address' or Lot No. W I +Ilt..... l IO.2w.ner r./...L. ............ ....................•--•--•-•----- -•._......--•--••--•••-•...._......_...........-- Add re--ss ns -•-•-----------•--•------ ............................................. Addres-s-........................................... PQ Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder a Other—Type of Building .. No. of persons............................ Showers a yP g ------------------------•= P ( ) — Cafeteria ( ) P-I Other fixtures ..---••-----------------------------•-•--••---•-___.----_----- d 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........................ Test Pit No. 2................minutes per inch Depth;uof Test Pit......................Depth to ground water........................ a - .... -----------------------------•-------------------•---------- ODescription of Soil..............................................................4. ---._'�. --------------------•-•----•--------•-••-•---•---•-•-••---•--------....•-----.....--•-- V ............................................................... ............................................................ ---•------•-•--•••--•-----...........•••--•-••---........_--------•---- W ....................................... N.....__...._.......__...._._.._._....._..........__.__.___..._____ __ __ __ U Nature of Repairs or Alterations—Answer when applicabh f * ; Agreement: l The undersigned agrees to install the aforedescribed Individual Sewagee''Disposal System in accordance with the provisions of TITLE 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`board of health. Sign -----•----•-- �' ` Date Application Approved By --- -- '- . . . . . ---- 'l�---7.f •----- ................ Date Application Disapproved for the following reasons---------------------•--.....-------•-•--------.._........----•---------•-------•-----•-•-•----•-----•••••_-••-- t.• ...............................p'i. ................................................................................................_._................_............._..._..__.....__.._..... Date _..... Issued.------•••-------•---••-............. Permit No................... -----..:.......... Date vY THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALT ,, + ..... ....... OF........ . ... ...... r+` �� f�rr�if�rtt�p of �uut�litt�tr�e r` I IS Tj CEE TIFY, That th Individual Sewage Disposal System constructed ( or Repaired ( ) by-- ----- ••___• - ----- •..... . . ......... Install at..."-"-.. �° !+�bC� �d.nc, --x--•+ �6 � i '� + l� ---- �.. -- --------•---------. has been installed in.ac_( 'A the provisions of T r of The State Sanitary Cc�i e as described in the application for..Disposal Works Construction Permit No.. ?�__._._ �_ 0.............. dated_:_. `.-....`"-.7 �................ r THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A•GUARANTEE THAT THE SYSTEM WILL,FUNCTION SATISFACTORY. IIE Ins DATE ---••-••-••-•............ .......••••••-------•--=..._•------••-•-•_. .ector............................................ P ----•••----•-------•-•••••--_-•---- THE COMMONWEALTH OF MASSACHUSETTS BOARD "F HEALTH N FEE........................ or #roman anti Perm*isiion is hereby granted.. / •-- rat->rr-l�1.... -----•• -��/�'_---�--------------•--... to Construct ) or Repair' ( an Individual Sewage Dispoff SysteYn f, atNo.------- ..lQ ........ ........................................... Street as shown on the application for Disposal Works Construction P it No. ____ - Date d.4 <�.. ............. AaOrdof Heal - DAT .." /b /02Tl ._....... FORM 12515 HOBBS & WARREN. INC.. PUBLISHERS