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Home My WebLink About0276 WINDING COVE ROAD - Health 276 Winding Cove Road `A_056 056 - ---- --- Mamtons Mills 1` l s I e I I j LOCATION SEWAGE PERMIT NO. VILLAGE INST ''L 'S NAME i ADDRESS B U I-L DD E R OARR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED -_..._ �� /�.� ` �! g' '� P / 7 � // 4 No...........!..o...... F:Rs......�2...s5............... n n THE�COMMONWEALTH® OFUACS>A CH r ETTS OF . .jj,:� . AeA...4....................... Appliratiou for Dh4poti al Works Tomitrurtiou ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an.Individual Sewage Disposal System at: 44- .............G�_ - .. ' -------------..................--.--- --- .---------------•............. ......... �LOCatl -A ess or Lot No. .. ... ............ ............................................................. ... .. g e2 Owner Address Installer Address 7°d.: q. Q Type of Building Size Lot...__ -._t-_____..____S fe9t Dwelling No. of Bedrooms............................................Expansion Attic_ ( ) Garbage Grinder 0 0) Other—T e of Building No. of persons............................ Showers — Cafeteria P4 Other fixtures ------------------------- Design Flow. .........5 _...3........._._ ._. lons per person per day. Total daily flow............................................gallons. WSeptic Tank� Liquid'capacity....... allons 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 ( ) O,rf,. ��_ _ /f- ZA Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (� Test Pit No. 2................minutes per inch Depth of Test Pit.............._..... Depth to ground water........................ ...... - . A ------------/ a O Description of Soil-------d-------�---•---- /! i�z... '... ............ -'L -- x 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 iIT p S of the State Sanitary Code— The undersigned furtl er agrees not to place the system in operation until a Certificate of Compliance has been s e the bo of health. Signed. .. ......... .........--------------•-- .......................... Date Application Approved By........ "-------- Date Application Disapproved for the following reasons------------------------•-------------------------------------••-----------------•------------- ................. ---------------------------............................................................................................................................................................................. Date PermitNo......................................................... Issued....................................................... Date .............................. No. Fmc THE COMMONWEALTH OF MASSACHUSETTS BOARD 0 A T ---------t .....OF............. E. � 4; ................. Appliration for Diiipviial Vorko Tuntitrurtion Vamit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: -1 ................ . .. ... ................;....... .................................................................................................. or Lot No. ........................................................................ •7 ------------------------------------------ ----------------- --------- ----- ----- ................................................................ --- --- OoF Ow per Address -'-�- ------------------------------------------------------------ ................ Installer Address .7 Type of Build Size Lot........ ...Sa. feet Dwelling No. of Bedrooms...........At�.........................Expansion Attic Garbage Gtinder'/V*� Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Otherfixtures ....................................................................................................... ........................... Design Flow ........./*----- lions per person per day. Total daily flow.............................................gallons. Septic Tank r—Liquid capacity.,V�.'gallons Length................ Width._......_._.._.. Diameter............_... Depth........___.:_.. Disposal Trench—No..................... Width... ......... Total Length...._.._..._ .... Total leaching area------------ sq ft '40---- 2 a 7", * , Seepage Pit No........./--------- Diameter-__--__-.r----- Depth below inlet ...... Total leaching ar .................sq. ft. 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 of Test Pit................_... Depth to ground water..._._........_..._.___. ........... ----- ............. .......4... 0 Description of Soil...... i .................................... .......................................................................................... ------------------------------------*.......... ------------------------------------ ... .................................................................................. ------------------------------------------------------------......... . ...................................... 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 T I T 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.issued by the board of health. Signed. ....................7................................................................ ................................ Application Approved By........ .. .. . . . .....4r......... Date Application Disapproved for the following reasons:................................................................................................................ ..........................................................................................................................7.............................................................................. Date PermitNo....................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD I 9f HEALTH ..................................... ..... .........OF.........4�... ......... T-pWrtifiratr of Toutpliatta TWHI.4v is CEIRT, Y, That the Individual Sewage Disposal System constructed (J�)A`®rRepairS4 ..... ............ x /............ .... .... V- ------------- --------- by _ Installer -V ... ................ 2 I. .... .. ..... .. . .... ...... . ........ ....... cco with f Tpe State Sanitary Codt. as desc� In the has been installed in accordance ith the rovisions of T11 j 0 Q� �Az application for Disposal Works Construction Permit No____------------ ........ dated--------Z--Z;F......................... 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 OP HEALTH ......... ..........OF....... .............................................. ...................... .......... Permi�siojr.1:60ftefeby gran t ..... ............................ �d...... . .............. to ConstrAt o i Individual %e�Di 6,05sal 5�aem 0 1 .... ................ _7 at No.110 . .......A............ ........ ----- s 'eet as shown on the application for Disposal Works Construction P t N( Dated----- .. ............... ..... . .........I .................................... d of Healt .............................................. FORM 1255 HOBBS & WARREN, INC., PUBLISHERS LOCATION SEWAGE PERMIT NO, VILLAGE a7c INSTAL Is NAME i ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED l9_�12G —' DATE COMPLIANCE ISSUED Y it ►_lam �aA(zSA�{: Grc�atd�1Z � , LOW _ Ilb x 3 t �3b G•pt7 •'t t ' V' T i. �. �El=-rlc TA.,•.lk. = 330,E {Sc % * �S 6 Pn. ': ' `' USA= 100C:�j 64L. I P X. � � yam. >< 1 .a . - SO C�.f'•D. � ( t , ; TO L. T�ESIG►.1 d•25 G , , � ToTo L b/sl L?( Fc.ow ' 33D 6.P. 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