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Home My WebLink About0894 OLD POST ROAD (CT & MM) - Health (2)"7 LO CAT ION E A G E PERMIT N0. /"-), ±,gl VI L LAG E SS INSTA LLER S N E i ADDRESS BUILDER OR OWNER j DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED a ---_.__...:.�.��-.-u....M._..��. _...__--_-..___._-- I � �` �i �� , f l� ��% �- � �y � �--� / �� .�,� � f J No...._....... .... - Fimic .... ..... ......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...............OF........ s" f .-------.... Appliration for DiAvoiial oaks Cnontitrur#iun Famit ,M Application is hereby made for a Permit to Construct (k or Repair ( ) an Individual Sewage Disposal �Q�w System at: ON ....C &Ab�. `-./1 .... .................................................... Locati n-Add s or Lot No. pit.1Z Owne Address a _...•••--1—-9'' . .A...... ........................................ M _T- ... .1 Q?:is........................ Installer Address Type of Building Size Lot_._ ,VK.�........Sq. feet = U Dwelling L No. of Bedrooms.______�w..0..... ........Expansion Attic ( ) Garbage Grinder (X) Other_Type of Building No. of persons______________________•._._. Showers — Cafeteria Q' Other fixtures ............................................. W Design Flow________. ___ r_____gallons per person per day. Total daily flow-------- .......gallons. WSeptic Tank—Liquid capacityl9 5Agallons Length................ Width................ Diameter_............. Depth________-______- x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.__`4?9 ..... Diameter.................... Depth below inlet,_.. _..._.._.. Total leaching area..................sq. ft. Z Other Distribution box (�() Dosing tank ( ) d a Percolation Test Results Performed ------- Test Pit No. 1................minutes per inch Depth of Test Pit_................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth, of Test Pit.................. Depth to ground water-------_................ 0 Description of Soil--... ...- -•-••• •-•--------- ........--=_ '. ---------••..-----•••-•- U ------•--.�� J W x •••••••••-••--------------------------•-•--••-••••-••--•-•-•--------••-----•-----..-••••-•-•-------•---•--------•--•-•------•--------•••••--•---------•-•-•--•-•-•--••-••--•-•••••••-••• ............... 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 iITLL 5 of the State Sanitary Code— The undersigned further agrees not to place th system in operation until a Certificate of Compliance has been issued by the b ar of ealg� j� gned. r ............................. -•- �/ / ate Application Approved By.....' -- •-•- .. G% ... { 7 Date Application Disapproved for the following reasons:............ _- -----------------------•----------}............................................................ .............................................................................................. Date Permit No......................................................... Issued...I Date No. ....... .... Fwa.......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ... i L t ...............OF....... z;rk61^-s . ...._... Appliratinn for Disposal Works Tonotrurtion Vrrmit ,N Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal �i`' System at: 40�h Pages b r a ce A�i s �+ca"1'" . ................_......... .... ... ............. - ............................. ............ Loc�at}i n-Addpss -.or Lot No +y�� jILS ,r own Address a ..........................! ...® _ter .---•-••.......................•......... --- 1t,) B �f ••/ 1 5 (�! .... ` ........................ Installer Address d Type of Buildi g Size Lot... � _.....Sq. .feet U Dwelling r No. of Bedrooms.._.... Q..... �^_...._..Expansion Attic ( ) Garbage Grinder (,' ) aOther—Type of. Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P4 Other fixtures ------•-•--•-----•----•--•------ - w Design Flow........ .....y; ..___.gallons per person per day. Total daily flow......... :.e_ .......gallons. WSeptic Tank—Liquid capacity.1 5?gallons Length................ Width................ Diameter..................Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No... ------- Diameter.................... Depth below inle .___. .. Total leaching area__...............sq. ft. Z Other Distribution box (Y). Dosing tank ( ) d ' /Py,`* 11 , �/,_ 7r '-' Percolation Test Results Performed by..TV►_19 6 �.___ Date_- �D-- _ ,7f'r....... aTest 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........................ a � O Description_of Soil........=........." ��I P'� �� i �J w U Nature of Repairs or Alterations---,Answer when applicable.................................'........................... .:...._..._........._........._.. .................................................................... Agreerrient The undersigned agrees to install the aforedescribed Individual Sewage Disposal.System in,accordance with the provisions of TITLZ 5 of the State Sanitary Code—The undersigned further agrees not to place the sy tem in operation until a Certificate of Compliance has been issued by the b ard.of ieal,K� • �. � ,.l� - ate Application Approved By.....tt%.... �._.... // Date Application Disapproved for.the following reason s------------------•-•----•-•----••--•--•-••----•••-•---••................................... ------......_ ..--------•---------------•-••------•-. -•-•----------.........................---•-----------------------------------------------------------------------------•- Date PermitNo.......................................................-- Issued-....................................................... :. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH (Irrtifiratr of TompliFatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.........A.k F`-P4 le 6.::...fX3......................................................... ,:---•-----••••••--.....•••-•••------•••...-•-•-•--••...•••-•-------••-•••......--•-•.............•. Installer at......0 ---•-- Q A��>.._.. - , ........................... has been installed in accordance with the provisions of ` 5 of The State Sanitary Code as described in the t....application for Disposal Works Construction Permit No .......2_. ----•---------- 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 .....t,t .C. ................OF.......... + :6l ................... ._........ n - No Disposal, Works T-Lono#r #ion. frrmit Permission is hereby granted............A " -4+�--hN .. 1P --•--•----------------------------------•----....-•---................ to Construct O or Repair ( ) an Individual Sey�,age Disposal System at No.---- T` ........QA�,. pem_m °"........&P. ............-11 M4.4 ?.�V......4111,ve.'s...-------- Street as shown on the application for Disposal Works Construction PP .it N . •.-_--.._. Dated....Z n141 `...7�1..... =: / oa:d of Aealt DATE------. F ... ..... ........................••.••... FORM 1255 HOBBS & 'WARREN, INC., PUBLISHERS �� - ' / ,-�;;lr i L.s�"J�.►� fir" .`,,,�; ', _ + 2e' 't,�1�°,, 47 y„ gt- iy '�(t.�4tfet�lti•.•,�,«,_ .�.6A i f'•��' d�,,,�, �.t� *� �� ,7 k� 'c�� 7 � f { 4 G.N t T27T'. ... 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