HomeMy WebLinkAbout0234 WINDING COVE ROAD - Health r
234.Wifidifig .Cove'Road:
Marstons Mills .E`tJ
1/0
L O C I-0- � ��- �y C�,e Ad E W A G E PERMIT M 0.
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r VILLAGE
INSTALLER'S NAME & ADDRESS
B U I L D E R OR OWNER
,a de-o
C ofiv r.
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
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No.-•-••-••--•......-A� Fx ............._.............
THE COMMONWEALTH OF TS
BOARD OFHEALTH
Y'
7.
Appliration for Biipuaal Works Tnnitrnrtiun ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: A
.................. ...... 13............. - �??j -Z .....................................................
Location-A ess Lot No.
Owner Addres
a . ............
.-------••• 06.. ....J�.l�. --------- 1 ' ?_.:II�.A4�1 Ic
Installer Address
U Type of Building Size Lot...Z $ 1�.....Sq. feet
Dwelling—No. of Bedrooms........:�................................Expansion Attic Garbage Grinder (146
Other—Type of Building No. of persons............................ Showers
a YP g ---------------------------• P ( ) — Cafeteria ( )
d Other fixtures
g gallons per person day. Total dil how__._.....n.0........................EWlonnss.�a
w Design Flow----•-----------�-- ------- -- -- t�'
WSeptic. Tank—Liquid*capacity-_ 040gallons Length...- .. . Width.. ............ Diameter................ Depth...-.�1_....
x Disposal Trench—No..................... Width........_....._..... Total Length............-....... Total leaching area....................sq. ft.
Seepage Pit No.....iPCo Q... Diameter........6......_. Depth below inlet....... Total leaching area...4!D......sq. ft.
Z Other Distribution box ( — Dosing t ( 1-12
'-' Percolation Test Resume Performed by........ B_. ._.... Date._ `? .'
...........
....
a ..............
Test Pit No. 1----------------minu.tes per inch Depth of Test Pi ... Depth to ground water_ ': .
fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
M ....----•-••-------------------•-•-•----.......-_--------------....---------.-•-• •.........--•---..........--•---------------.........
O Description of Soil-----•---•�...........tao.A eJI t2.k.... 1. -------'--I�-�!-----•C R k,a.-J......M.tb..... -
xdD.....W..&`r tk---------------------------------------------------------------- -----------
M
V 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 TIT I, 5 of the State Sanitar Code— The undersigned further agrees not to place the system in
operation until a Certificate of4o ian ha issued b the b
? oar of ea
'��
tgn .---• - � ---• ---• --••-•---- ..............
Dat
Application Approved By............................. --•---- . . . . .----- ............. ......... --a 1. 2L....
Date
Application Disapproved for the following asons:..............................................................................................................
.. .... ..... ................................••--------...-------••---'------------•-•-••---•-•------------------•---------•-----------•------...- ----......._
Date
PermitNo......................................................... Issued.......................................................
Date
,
l
C -•7 _ �i v
No......................... ..a Firm. .S
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Apphration for Di ipmal Works Tnnstrnrttnn runfit
Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal
System at:
.. .. -----............... ......•---------------...�::�........... ----------•----------..............
Location,Ad ass
•--•--.......... <!'�l da_ ... t , -!4��!`f p h) - ........... ==... ' 1 ... .............................................
IAc fK°......�� � l.?4.�,1�.J
ner _,Address
Via. I � .... l i ...................................t.> a. -
• Sq. feet
� Installer Address _
UType of Building Size Lot....: : S_L• ._..
Dwelling—No. of Bedrooms......... ................................Expansion Attic Garbage Grinder ( ► )�j
a Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Other fixture
W Design Flow.................��_________.........._..gallons per person r td�y. Total daily-flow.......... �P)...............--....._ lons.
W Septic Tank—Liquid capacity...!"..gallons Length....--_'� Width...`:.?'... Diameter..
-------------- Depth--------r----
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No.._.._1 CP_P.. Diameter......... Depth below inlet.......,........ Total leaching area....l�'�►�.....sq. ft.
Z Other Distribution box O Dosing tack ( _
'-' Percolation Test Resultsc Performed b ._._._...�z -�.._ _ -- ���
Date ----------------- .................
a Y t i C�11^E' v�
III
Test Pit No. 1________________minutes per inch Depth of Test Pit_�_.__1...�_�_......_ Depth to ground water........................
rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
P4 .•••--•••----•-•----••••-••••••--••--•-••-------...••-••....................•---•....._..-----_.....--•-•---•-•---•--- ------------- ... ............
O Description of Soil...---------�=-...-•-•-•- '�' "�._. ..._"'a U t�...`'�!- --------- I Z� .-.-C 1,A'-A.4 = �',�_� '_ S71 � S
x / L� • -----...... -••-•-.---•-
s�.t� `t .....
U
W
UNature 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 TITL%, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a CertificateCompl' n s been issued,y the bgar of Health:i
Sign r l�_y.� i, .°. ` 1. �.�r''Y'( �' � Ll
Dat
-J,
Application Approved B ......._ 4 !! ____ _
Date
Application Disapproved for the following ons:--••--•-----•••------••--•-----••-•----------------•-••-•••--•••••••---------•--•---•-•••-•-----......•---•••-
, .
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.............t..(aV•11.�
..........OF.........
� .t� �G ". :��:.
. ..............................
Tntifiratr of Tomphaurr
THIS IS TO CERTIFY_, That the Individual *ewage Disposal System constructed (�f) or Repaired ( )
by..------...n4 . ._._.... JZ 1,.1_ .... C•,fin!T -S� I j!L1. -
-•----------------------------------------------•-------••---•----•---
I�taller
-••---------------------------•--•- ra •••--
--------------------•-----------•-------•--......-------•------••--•-----------.
has been installed in accordance with the provisions of TITIE 5 of The State Sanitary Code as described in the
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................................................................................ Inspector....................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD_OF HEALTH
No.... .;.� .._......... FEE....--••................
Ulan rrntt#
Permission is hereby granted...................._.......ft... C_I u1 ...----• �-•�-N-- --------------•---------------....-----................---......
to Construct (X or Repair ( ) an Individual Sewage Disposal System
at No..................................................��.`Y..... t.:).�.:�x C �
-J Street
as shown on the application for Disposal Works Construction Permit No&C -_,_1 &Dated..� 144...__._....
----••-•-------•----------------•---... 1 ! - ---- ------....-----...........
DATE Board of Health
•---------------------------- -------- t�
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
D Es' 1G-N Df:\T/a
S I NG-LE 'FAM I U_ 3 SC-Dt2.nn PI
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No fsA�Z�ACsE GI2ttJ DCtZ.
DA I L-Y FLov./ = Ito x 3 = 33o G.P D
SEPTIC TANK. = 3 3 o x 15'010 - 49 S G.I'• D• ,- 125.o o
USE 1000 GAL. TANSY, ,
La T ZS
(D�SPosAL Ps-r --- QSE W (000 GAL. ;2 s�o s.r
SIOEWALL AR-EA s ISo S. F.
1570 S.F. $, 2 ,S 37S Cr: P. 0.
8n-TroM A9-EA = So , s.F.
Lor N `�T
TOTAL- t)GSI&Q 4zs- G. P. D. 2p 93 '... ..,. :Eg.1 �t z7
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o Z M,r,1 .0 2 LE SSi �► =-_ ,
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