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Home My WebLink About0155 CROCKER ROAD - Health # � e L`�t�•�?�, 9 .#r�"',�fi.d e °�ac t*��stfs: P.{Y� 1� y z Wiwi, _...p.. ,. e :^ "� rh♦,.'n. All, R rx`}; c W k a w 3t ...,. * 3 .'i.k ._n,.... . a.,.. r ky ..,. a+.. ... , t-. S ti• s°. .... e.. 4 y..>.. u•-,... -.d r',: •...'w^sYk: <�.: g ...,x :'L'r ,,,_S s r... *z R,. ., kk i4,eT,Y..,.. ..� •-•, t,,,.- .5.-. ., � �, •.,_,er. . r .4.,:.e ,<�<, .� ,<.�� :_ t h r ..... _ �r`.t "A �a ti l ,,..,.,. ,. ...,a ....,.v.. m. .. �..:��t. .n. ,. s.p+:r.,.fi ,.qq4 x .a ,.N, s7.. ..- _ s .. v>•, yy r„§. ,h.,..y,,, i s _-,r .:',�,' �- a^ t,. p f R,w. .�{ .,, tli� ,-..,. c,t-. .. ,. :r. .,.. p,,.: ,..♦-. ✓1�.n.. f. S,n,�: .._. sf, ..... . .,. � .t..b ,,. c :}. ,vr'.,� r. 'S., ..h.: iN .,t.', 4t.. .,. ,. r,.__. _., P .a Y'Y�..x.. r r w.. .:.. a:.v. '� -•, '71� ,. ,� ..., ,. ,. .:. � .:. e � +.,\ ,.,:,.. .. r.,, r.,_ .1 ,. .n-•. w .c. f.?: ,: ,_ t tY'..!.s _,,. x 51 ^ -E ,.t. .'4•. tx. .' +• ai ^.` 3 a :'S ..7C.� {,,. ,roti r, .� ,a�, F. • :': { »��,Y},� {+t s,�$v,?, k j .y y: rt fi >� °" 'n a">>„ t,��3:. , jj / T 3 1, ca 14, , x r , y ti ` r ♦ , . rh' FF " t , k 1. r -• ,. �, -, .I -�. .. .. ,. [ . .. ., , '. , � q '., .. \�x '.L •, ',- - ,...' 1 rr a .. , !Eta' • 1 e, •a , i � r y It : G s , , r : r.. i .. .. .1 1. • • � s, a t _ 5 ' ° N''b....3."�6.�:.... F�$...`��................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH XpV iration for Uiopoiitti Works Tonitrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal ystem at ..� s. r_..t1.0._._.... 6 _ '..2 .------- (rcc `�� .....t.....�c,e................ ... .Q V Location• ddress or Lot No. l e�►� �L .jar.. ............................ , ......------ . Own /� ` Ad ress p a ..............':..'.......• I... •• ..... .--. .. .!P ................. ......... Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.............3.............._..._......Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ..........0.............. No. of persons.........3............... Showers ( ) — Cafeteria ( ) Q' Other fixtures ......... d ........................ ...........----- -------------_.---------------•--------------•-•--------------- }}�� ...--- W Design Flow......... ......gyp ....gallons per person per day. Total daily flow......c3 a..Q.....�?f�.......gallons. WSeptic Tank—Liquid capacity.l�d..gallons Length.. Y:4_.. Width.g..q.4.. 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 ( ) Dosin tank ( ) ~' Percolation Test Results Performed ..................................... Date...J__.!�:'1.3.............. �a Test Pit No. 1_ .Civ 2..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........................ �j .......................... ........------------------------- ._..............a....................... .......................--••.......................... ..... O Description of Soil-------�e�.A `---.....5-^ --S-S?.....I.........n.!Ip.-----•-•....JN�_�rD�v ._�.12.u_r .w. x U --•......--•---••......•--......----•-•----•---••••---------------••-••-------------•-----•...----•-.......-•-----•-•--•--...---•-•....--------•---•••--••••••-•-•••-••-----•------•---••--------••---•- W ......................-................................................................................................................................................................................. VNature of Repairs or Alterations—Answer when applicable.........................1..........................._......................................... ------------------------------------------------------------------------------------------------------------------------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage`.Disposal System in accordance with the provisions of AITIL- 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i ued by the board of Health. Signed ........�L... ........................ .. ----------- � ate Application Approved By.......... •.... :_._ �'' ................................ - Date Application Disapproved for the following reasons:................................................................................................................. .................•---•-----...........-•-.....--•--...-•----•------------------••--.........-•----•---...............................---••-••••-•--•---•--------....------•---•-------------•-••......... Date PermitNo................................ ---------•----•------. Issued........................................................ __-------- -- - Date I�ro 3.. .�...... FEs..-4"' ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................................... .....OF................................. Applirtttion for 14spu,sttl Workii Tonstrnrtinn 1hrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 41a ... �? ..�.5�!C. t.r---1�D....�.�: c:StUlr.....--••--......�... . ........... Location-Address or Lot No. L C ti c L.t�......1 C..... � �'.►+ !'.!�............................ f............?.�......�.u=..!: .....�to�.......... Owna� Address a .............•...... ................ .. b. S......................... (a✓w ��r Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms..............3.........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ..........C.�.............. No. of persons.........a............... Showers ( ) — Cafeteria ( ) 04 Other fixtures ------------------•---•---••.... . . . --- --------------- W Design Flow.......... ?3......(v_PL)._-gallons per person per day. Total daily flow_._...`3:?..0......6. .......gallons. WSeptic Tank—Liquid capacity.lLt4a -.��..Y`.gallons Length. .�... Width.7.�/:k._ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length........'.. Total leaching area....................sq. ft. Seepage Pit No.............,....... Diameter.._......._.._...... Depth below inlet...f.............. otal leaching area..................sq. ft. z Other Distribution box ( ) Dosin tank ( .,) d` f Percolation Test Results Performed by... a,v><c!-.. °lu- - ---==------ .......f-............ Date......=_!_2..:.kj..._.......... Test Pit No. 1_j.�.a,Z,-_.minutes per inch -Depth of T§est'Pit.................... Depth to ground water........................ Gz., Test Pit No. 2................minutes per inch Depth of;,Test Pit.................... Depth to ground water........................ a / ---------------------------------••-----•-••----•-=-----•-----.......----------...---•---------•--.----------.---- •--.-------._.-----------------•---•----- 0 Description of Soil......./a-4-Q A.....---a.........S.,. i_.LS Q}•:..1.......... D L',----------- roe`"el��u..,.� �(3�r S €----54-4v U •-•••••----•--•-•---------•----•------•-----••-••••--•••---••••-•-•-•-••-•--••---•----•---••••--•-•.....-•--•-•-•••-•.......•-••---••••-•-•--......•------•.........................•-------._..._..•... W VNature 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 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 4issssued by the board of health. ._.....1.G Signed.. . ,Lj- ate Application Approved BY ...�..� 5�_��e�'s�... -- Date Application Disapproved for the following reasons-------------------------•--------•-------•-•-•---•--•--•••....---•-••---•-•--....---------...-•---..........-- -------•--------------•------•-----------•----------•-----..... -------••--- ---------- .-...----- --- .... ..........----------------------------------- •-•------------- •-----------------..._.. Date PermitNo......................................................... Issued-........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f (........... ......OF.... - !^ ................................. C�rrtif irtti of f��am�littnr�e , THIS IS TO CERTIFY, That t Individual Sewage Disposal System constructed ( ) or Repaired ( ) by...................... ==r ........ ,1 --------•--•••--••••--...... Installers at................ ..._ .�- .....---- "..---•-•--`" '--....•...-----•--------•--------•---•..................•-•---................---•---- has been installed in accordance 'with the provisions of-TITLE of The State Sanitary Code as�descr ed in the application for Disposal 1Vorks Construction Permit No......... _...� y''_....... dated-........._qjoln............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIONS TISFACTORY. S pJ a DATE................. ......................................................... Inspector.........................................-----•--...-•------.......-----...--•--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Q.3-�"�q ..........-••--••.........No .[... FEE....................... i g 1a nrk %ov.,iotrurtion rrmit Permission is hereby granted.. to Construpt ( ) ofj Repair ( ) an Indiv'. 1 Se wage Dis System-a- at No....... �o7..t.... '"'.. ....--. .:4---:----4..---•------------ ....... Street p as shown on the application for Disposal Works Construction Permit No a-_ .: �'�Dated.... .....:...�.3� -p __-_ ........................•-_..... •-•----...... -•---............... Board of DATE......... G:. - FORM 1255 A. M. SULKIN, INC., BOSTON i L0 CATION '7WI41e V1& SEWAGE PERMIT NO. VILLAGE J"INSTALLER'S NAME i ADDRESS I - , 1 NSUILDER OR OWNER ®DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 5� �� / �.E►�� c� s AIN,, 0 L/ u4E /otoo-gS,4L' ; ! ! �G j� • { r it � �' .Ca'T"��- �1 AL.L A L" = /3 ..s i Bo't'tow► AReb 1�OV1`1 QAl'tON ToTa�- DFS�Gw1 =41, 3e?6,tp. : . \ �. '� I 1 I ^ 4 i ! ; 7a-,-.A•L ;T.a4�L�/ .3v • Q � � .lI -1 pF�Go�T c ow. 2A'T�: l I u '� M16.! 02 -9., , �: ,cr I. A.-I A. No. 19?34} `. 4 AA ho s tr+tti I ( i ,t- ,~,; :._...: : .: .._. .. .�, -: : V. . :. i . . 0O 0• . Top Fop • ba. 7tzF . q . .. F Z;.. .. 7, - wu . I LO^M r �""PPE I000 IwIV: "f y7 0 1 ua: !oil . : . . 4-PPG ao� 9yG wv Sic VJITr•6 lit wAsucW . .. I C E 2_ T l fr Q E D Pt--o-r Pl-A+.1 P,tZo Ft L�r l-�A.rta►., f -7 ( .. . . . . +Jo Scoff SGht_c-. - - f / 63. 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