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Home My WebLink About0086 GREEN DUNES DRIVE - HAZMAT (� G r ter, pu h es D r fi v e- ceo4cy v i, I e- B THE COMMONMiEALTH OF MASSACHusETT3 BOARD 9F HEALTH :... ' C.v./�........OF........ � _09 ..SAW. ... ----------------------------------- Appliratiun for Disposal Murky Tonstrurtion rrrmit Application is hereby made for a Permit to Construct Repair ( „) an Individual Sewage Disposal S,"' ty- '...... 0 Locatio "ddres 2 orCAM ...Af. ........ ... .. S,M.i.A...... . A..... ......... ._... ..............Address.. Installer Address � ��yy Type of Buildin� Size Lot. ..!�, ✓...Sq. feet Dwelling=No. of Bedrooms.__.....1 .............................Expansion Attic ( Garbage Grinder 44 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ) Other fixtures d ...----------------------------------------------------------------------------------------•--...-----f� ® .............. WDesign Flow.................`��.................gallons per person per,days„ Totalr pil Pow........... �.......................Olonj WSeptic Tank—Liquid ca.pacitylt�gallons Length-.��):-L.. Width..::...,.. Diameter................ De th x Disposal Trench—No..................... Width................... Total Length............ Total leaching area...................sq. ft. Seepage Pit No......a........ Diameter.......�0.... Depth below inlet.._.......... Total leaching area.................sq. ft. z Other Distribution box (�!� Dosingnk �r aPercolation Test Res is Performed by... ....-.l�Cs Date... tr ,.a Test Pit Nn. )�Z....minutes per inch Depth of Test Pit... ..� ._.. Depth to ground water.��.U'r ..Z� LL, Test Pit No. 2................minutes per inch Depth of Test Pit......../ -.. Depth to ground water._..._.........'.. R; ...........p ...... .......... - •... ------------- O Description of Soil_...... .. ! .��,� .... � ..- ...................... v ------•--.......... -•----------------- ......... •••-•........ - *------- ................................. -------•-------------- W U -,,,Nature;;Nature of Repairs or Alterations—Answer when applicable............................................................................................... •..................................................•-•---....................--•---•-----------......-•---............------....----•-•---••----.....--•--•--.................•••.................•_---• Agreement: he undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with th ovisioiis of iITj," 5 of the State Sanitary Code—The undersigned further agrees not to place the system in ope atio /U 'Cer 7cate of Compliance has beelvimed by the board of health. ....`...---•--......-•----•-••--------------------------------------•••... . .. ....... A' • ication Approved By........ ........ --- ----•-•-•--....-•--------•.............................•-•--........... .. .�. ---�"..ace -•------- PPlication Disapproved f o the lowing reasons:..................................•---........................................---•-•------.......--------.--_ ..........................•--•-•---...........------....----•----........---------------•-------•----•---...---•-•----•------.......................------.............-•-••-------•••.....--•-....._.._ Date PermitNo.................................................•.. Issued......................................................- Date - --psi THE COMMONWEALTH OF MASSACHUSETT9 J. BOARD F HEALTH ............OF....... ............................................. Appliratiun for Disposal Works Tons#rurtion Wruti# f Application is hereby made.for a Permit to Construct f� ) or Repair ( ) an Individual Sewage Disposal S item sat, ' ` Locati ddres //�� or } g ••• ',J :. .�::.- ... I .. .�.�: .. f_ .. r ;_. , ....... � padre g....... .......................................................................................---• -•----- W .......... astaller Address `� ,/��r Type of Buildin Size Lot. ��t.,1-M4 '')....Sq. I t U Dwelling—No. of Bedrooms... ....�� ..............................Expansion Attic Garbage Grinder pa Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ) 04 Other fixtures WDesign Flow................,`.2.................gallons per person per, day., Total daily flow........... .f C....................gallons. WSeptic Tank—Liquid capacityttt .gallons Length..,/i!.!Z.=&. Width.5.-.9-._... Diameter................ Depth 5..__7.... x Disposal Trench—No..................... Width.........i......... Total Length.................... Total leaching area...................sq. ft. Seepage Pit No......�......... Diameter.......1,n3.... Depth below inlet............. Total leaching area.................sq. ft. , Z Other Distribution box (1,4-"'-Y Dosin nk ( )) f. Percolation Test Results Performed by.._.i-) .. +.. -1 ..»-. � .. Date.. .-�.:------------------ Test t ,.a Pit No. ....minutes per Inch Depth of Test Pit... ..� ..... Depth to ground watery Uhl'..�{ G4 Test Pit No. 2................minutes per Inch Depth of Test Pit......... .... Depth to ground water........c°........'... ................. Description of Soil...----.---- .�..... .......... . ................ V ........... •............. ........•-----------•--..---- ----...... ---------- --.---------- ----- . ............................ ........--••--------------------------------------------------------------•-•----------...-•-------.....------......-•--------••------••-------•---••••••••••••••.........._•--••-................-•--•- UNature of Repairs or Alterations—Answer when applicable............................................................................................... ..--•-•---•..........................••--•--•--•-•--•--•--....................:.--•--•-•--••------...-•---......--------••------...---..............-----•------................---•••.................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with tl ovisions of TIT � 5 of the State Sanitary Code— The undersigned further agrees not to place the system in op ,ati a sate of Compliance has been-issued by the board of health. Sied .s. ..............•-••-•..........••--•--••-••...........----•••--•...•--.••--- •• . •.. ....._.... Apication Approved By...... ..... ..............••--•-•----•............................_ ..Zr. . .. .. .......... ate PPlieation Disapproved f of e llowing reasons:---•-•-•----•--•--•--------------------•---.........----•--•-•-•-•-••-.....✓✓---•--...........--•••--•-•-.._»» --•.......................•--•-....................---......------•---........--•-------•...-----------»......-•-•-•------.......---.......----••---......................----••----••--•-...----....._ Date PermitNo...................................................».... Issued....................................................... Date 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EAUW_ £ .................... ................OF.. .......... ............................................................... r�x Trrfifutt#r of TI-Impliana za T -M 0 - FY, That ft Ind vI ew Disposal System constructed or Repaired by.....=in -.._. Installer ................... -•.............at...•-•• �.. :'' . --...-•---•----------•.............•--•-•-••-•--•--•-•----....--------...--• ------ --------•---. has be with the provisions of TI F 5 of The State Sanitary Cod s de, ed in the application for Disposal Works Construction Permit No ..-r.!�?r. , -..__...._. dated-. ,��.....4', ..,r. .............. THE ISSUANC OF THIS CERTIFICATE SHALL NOT BE CONSTRU D AS A G ARA TEE THAT THE SYSTEhA W F CTION SATISFACTORY. DATE`3. 2.. ...... ................................................ Inspector .. . ........................ THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH t ........... ...OF............. ................................. F .°...........». 3�isosttl, , onsi#rnr#iun rrnti . Permission isAi eb anted......•..._.._ _:_ +y.granted.. �,Ga ......................... to Construct ")�or''Rep�air ( ) an Indiw-' ual Sewag .D' posal System at +'r fY' reet as shown on the application for Disposal Works Construction Permit No..................... Dated, . / - ............ .........................•-•••--•••••-••-- -----...•-••-...................... l Gp DATE............. ..........................................•....• B,p�ard o Health FORM C-1255 CITY& TOWN FORMS, INC. 369-9708 r Z Wit`fbsEv STY td-)_ C'c �o - Ll.S 64 off- I lwv �1.A1 �4�0 ��, �',� ors `� PI M 4 Lv cu m t s try ` I <f-- -kr"djQ- Tkltl� �—� � �—: , �A , \/&,7— VIVL OF S[��T�1ti-tS = Z► XI S 1 +'� SZs. G..�'D A�',q ti 1` JA„� . Q Z k t. X 1� �. NES zi i �...5 = � 251 rN YE