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Home My WebLink About0024 MARSTON AVENUE - Health (2) � �f MPRstoN AJ &�q8 jp THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH' v • " F .��lutt�uan .flax � ��n�tt1 nrk� Cn��t��rixr� un �rrmi� ,�.,_ ..� Application is hereby made fors a Permit to Construct (��) or Repair ( .:.a1t Individual Sewage Disposal System at: V� { -'Location ddress __. - - c` C _._ ..d. .. t No .`cM4c 9 _..... .. .. ----- y/� O0wner n a Add x - ............. •`i � .................. InstalleroA3dress Type of Building , } . °' - Size Lot••--- ...- ;Sq. feet ' 1-1 Dwelling=No: of Bedrooms..,-- ..............:.... ...,.__Expansion Attic~( ) ;Garbage Grinder ( , ) a Other—Type of Building ' No. of persons Showers a YP g :..•. P e ( . ) , Cafeteria Other fixtures ) ............................................................. Design Flow gallons per person per day. Total'daily flow-...... ' �..... gallons. allons Len th C Width ___ Depth W. Septic:Tank.-Q•'I_iquid capacrty�, -�g c g _.... ------ �t. - Diameter------ --------•--- .� • x Disposal Trench—No.. ..�.._:__ Width______.__._ _. Total Length...��_.. Total leaching area...:_ q. t. ° s { 3 Seepage Pit No..::......: ...... Diameter ......_.I _...... Depth below inlet_,., Total leaching area....................sq. ft. Z Other Distribution box (` )' Dosing tank a Percolation Test:Results Performed by .............................. - Date- t Test Pit'�lo- I................minutes per inch Depth of Test Pit..............f:... Depth to ground s*water......::._:............. v r f=, Test Pit No. 2................minute's per inch Depth of Testi Pit .........:....... Depth to ground muter :.___ = O Description of Soil............ ....................:... . �._ ' W —-- ------------- ............................ 3--- - ----- ------ ..... ........ ....... --_---_-------------------•---- __-----. ------------:-------. ,---- « •------ - --- V Nature of Repairs or Alterations—Answer'when applicable Y I( -.4 ........ _.... 3 ........ Agreement:, The undersigned agrees=toi install the aforedescribed Individual Sewage Disposal System in accordance with the prgvisions,of iI:U , 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 AStgned �he .�. -._,._-..c_ _._. . .- ...__ . ...--- --- -•-•--- _ . . x 1 Date Application Approved BY ;. .. - l,�c ` "^� .. ..---- -•-•-- . _ 9 Date # Application Disapproved for the following reasons:................................................ -- ----- = - .................................................... ....................................... --••-- rt Date ' .Permit No._ ... �v..3L... .. f Issued:.---------•--. •• -- •------ .. ; Date r r, Fzz THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �. `_2X�........0FE-�'.. :.'R SZ.. �n ... ................... Appltration for Disposal Works Tonstrur#tun lIrrntit Application is hereby made for a Permit to Construct ( ) or Repair (%.)-a-rr Individual Sewage Disposal System at: U�• ........... .� ,s fl i ....... __.,------•--•-••-- y ............................................... '. -Location - ( .• .....__•..•..•. :Address r Lot No ...................... ...................................................... Owner Address Wq —1— -----------•.. ............ s� C................--•---•.......................a Insta.ler Address Type of Building Size Lot...-------------------------Sq. feet �--� Dwelling—No. of Bedrooms...:�.................................Expansion Attic ( ) Garbage Grinder ( ) a'4 Other—T e of Buildin yp g ............................ No. of Persons.._____...___.__.____...__.. Showers ( ) — Cafeteria ( ) a4Other fixtures -------••--------------••---•-•--••---..•.....---••--•----•---------------•---•--------- ••-•••••--....---•••-•-•----....._-----•--------•-••......... W Design Flow......_= _' -......................gallons per person per day. Total daily flow--_--_.�_ . ______.._____._._._gallons. WSeptic Tank--Liquid capacityt IVT61lons Length ..... Width---�.-/........ Diameter................ Depth................ x Disposal Trench—No...A.............. Width......!7......... Total Length�:_.��._..K...... Total leaching area....................sq. ft. 3 Seepage Pit No-----------------_- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date.................................... 1.4 Test Pit No. I................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........................ 9 ---•------••-------•----••-•------•--•----••••••-••--------•--•...---•-•----•-------•-------------------=-------------------------------------------------- 0 Description of Soil........................................................................................................................................................................ U ,-----...--•----------•-------------•--•-•-•--•-----•----------•----------•---•••--•---•----•-•----------•- 4 W U Nature of Repairs or Alterations�—Answer when applicable.... --------- w ta�S Y) fi r_r.� ( "`1 t �'k 4 ................................. Agreement: � f ' 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 furtlier agrees not to place the system in operation until a"Certificate of Compliance has been issued by the board of health. ___ Signed.:-'• "`.......- tv ---�.. •. •---•---- Date t Application F Approved By _.._.....`..."#V V ✓ ----- _D ate heftloApplication Disapprovedfor towing reasons::.............................. ... .....................................•-•-------------•-•-.------------•---....-•------........------............------------..................--•---...•-----------•----...............................•- Date , Permit No.............. •-�-- r/_3/---------------- Issued-....................................................... Y y+ Date THE COMMONWEALTH OF MASSACHUSETTS f BOARD OF HEALTH { 4 ! + .........of..�.06'.v...... `rt'.............................. (Intif iratr of Tontplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired IJ Installr has been installed in accordance with the provisions of Ti=L j of The State Sanitary Code as described in the -application for Disposal Works Construction Permit No.............�9__.$'..t...1-/—. dated_.............................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....................... ........1.... / t Inspector.. _ t -•................ t � b----------------------------------------- THE — _-------------------- COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .... FEE.... ...... Disposal Works Tonstrnrtiort Frrutit Permission is hereby granted............�''.VA OC- I:.A'1_.tJ ,S- ,/T ;' C............... .... .----.------ to Construct ( ) or Repair (—`) an Individual Sewage Difs�p-ossallp System ` � T ........................................... - street as shown on the application for Disposal Works Construction Permit No.Kk7*34__ Dated.......................................... p DATE..................... _�_.�.�..•'--`�---5'------•----------------------• U Board o f h ealth 1 FRiE....2, THE COMMONWEALTH OF MASSACHUSETTS BOARD F h-9 EA T a _. -. ...-.. .oF .... . _ .... .:. ----------------- Applirttt nn -for Ditipwial Workii Tomitrnrttnn Vrrtuft.; '{"y g- Application is hereby made for a Permit to Construct ( ) or Repair. { an Individual Se ge Disposal i 7 *. Syst at . '.I ... ... ... ... .............. ... .. .. K_..�y.1._.._................ ....._......._..-_ _ --- .......... ......_.__........... _........ ----------••--- V,I. Lo ti Addr s or Lot No. ________ ________ �._____ ____ ___._____ r _. ...--......_......................_._..._..... ............ ....... __ w dress -------- -- -------------------- I er A ss Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) a4. Other—Type of Building __--- -------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) 0.i Other fixtures ...................................................... W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons. WSeptic Tank—Liquid capacity__-_-..__gallons Length________________ Width-------......... Diameter---------------- Depth................ x Disposal Trench—No_____________________ Width-------------------- TotalrLength___-_-___.________-- Total leaching area.......-------------sq. ft. Seepage Pit No--------------------- Diameter-------------------- Depth"bed w inlet____.._____-._.__-__ Total leaching area-----------------.sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by-------- ----------------•--•-----•--------•------------------------------ Date---------------------------------------- Test Pit No. 1................minutes per inch Depth of "Pest Pit_................. Depth to ground water.._.__.__-_.-._.--.__... 44 Test Pit No. 2----------------minutes per inch Depth of Test Pit.------------------- Depth to ground water-_._-.-_--_.----_-_.___- a' --------•-••-------------------.............................................................................................................................. 0 Description of Soil------•---------------------------•-•--••------••---------•---•-•---••------------------•--------------------•-•-------------------------------------------------------- •---••-•--------------- --------------------------------•------------------------------ - ------•------ y V Nature of Repairs or Alter tions Answer when ap le. ��'� - "" �/` ---------------- �� ------------------------------------------------- Agreement: The undersigned agrees to install,the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued the board of h lth. Signed---- ---- ---=----------- --- --- - C�y_ _._. .. ! D --- - -Application Approved B De Application Disapproved for the following reasons: --........................... ..... =-----•------ --- --•--- --•-•------•-----•------------------------------------------- ---------- Date PermitNo......................................................... Issued....................................................... Date No. .I_.`"f F>>s....,�L.I............... �� THE COMMONWEALTH OF MASSACHUSETTS BOARD F F9EA T .. ..........OF.... -:... . ........ Appliratiolt -for Di-qVniitt1 Workii Tonstrurtion Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair. ( individual Sewage Disposal Syst at t / e „• Lo ti Addr s or Lot No. -------- - -•------------- -------- -- -- ........•••' ---------------------- ----••---•-- w dress In a er A ss UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.......................................7..,__Expansion Attic ( ) Garbage Grinder ( ) pa, Other 'Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) G4 Other fixtures --------------------------- .: W Design' Flow..............--------------------------------gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity------------gallons Length------------------ Width................ Diameter----------.----- Depth.-.----_----.... x Disposal Trench—No_ ____________________ Width-------------------- Total Length--------s.............Total leaching area--------------------sq. ft. Seepage Pit No_____________________ Diameter.................. 'below inlet__--I................. Total leaching area------------------ ft. Z Other Distributiori•box ( ) Dosing tank ( ) aPercolation Test Results Performed bY---------------------------------------...................................... Date---------------------------------------- .a Test Pit No. 1.................minutes per inch" Depth of "Pest Pit.................... Depth to ground water...-----.--_-.-._-.-...- f4 Test Pit No. 2----------------minutes per inch Depth of Test Pit_................. Depth to ground water..._...--_-__--._-__-_ a •---••--------------------------------------------••----•-•-••••••--•-•------------•-•-•--•-•--•-•••......................................................... 0 Description of Soil-------------------------------------------•-•--•----------•-----•---------------------•------------------•-•--•------••-----------------------------------•-------•--- V --••------------------------------------•---•-•----•-------•-----------------------••-----------•------••-----------•-------•--•----••------------------•-•------••-------•-- -----------------------------------•------------------••-----------•-------•-----------•-------------------------------------- - • ------ -------- U Nature of Repairs or Alter tions—Answer when app la._" ___�.�- ____! _. _:___... = ` - �J�/!//�i ----- ------------__................. -------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article \I of the State Sanitary Code— The undersigned"further agrees not to place the system in operation until a Certificate of Compliance has been issued he board of h I the igned_._= ------ - _••-- - /Da Application Approved BY ' ---- �. --- - -- � Application Disapproved for the following reasons:--•----•---•-------- ..................................................... ---•-•---------------------------------------------------•--------------------------------------•-------------------------•-•---•----_--•••----•-•-•----------------••-------------•--•---•---------•--- "' Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HIE TH .. .........OF.............. ..... . . .:........ . --......"..............:. PI'tt$j a of Ilmptialtrr I S CERTIFY at e In e ge Dis osal System constructed ( ) or Repaired by....... •-- •• ----� ••--• ---` ----- - --- --------•-•--- ------- -• ---•- In er 00, has been installed in accordance with the provisions of . rticle. I f,,The State Sanitary Cod desc ed in the .,pp� application for Disposal Works Construction Permit No----------_____________�(,e_......... dated------- __ ..!!.._. ._.__1�--.�__.__.__ ' THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUED AS A G RANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector................................................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH t d"Zf OF......... % :....+t ..............................: r No. ---• FEE.. -_.... Di v w o at s Itr �ilill '. it Permission is hereby grante __._ --- --------- •--•--• --- ---X-- -----•-- ---•---- ... ..................... ....................... to Co _ uct ( ) oR•epat, an I iidual Sewa isp .a] System •` .7 -----•--- # - ---- Street as shown on the application for Disposal Works Construction it N ...... _ Dated-.'...... ----. � r . ---------------- DATE------- ---1�. ....- ' = f Health BOa' o FORM 1255 oess , WARREN. INC.. PUBLISHERS i - -- ---_ _ - - --------- ---- - --• --- -- -_-__lam--� _ --+�_',..-_ 47 - -- - ------- - - - - -- --- --- c - r �