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Home My WebLink About0067 MEGAN ROAD - Health (2) �-r �m�� a�, �+�1 - a9a - asy j — No.. ,/ Fizit.i..V...�..... THE COMMONWEALTH OF MASSACHUSETTS BOAR® F H n . ....... ...�.OF . ....... . ........ I Appliration -fur Riivviitt1 Works Chu trurtiuu Prrutit Application is hereby made for a Permit to Construct ( or, Repair ( ) an Individual Sewage Disposal System at: ° - ---------- L ti d ,`�L{�✓� or Lot No. ..............�, .1.... .. ............... ........t....................... ..........._....-------•--............._......................_................................... Ow r Address W ........ss........� Installer Addre --•---------•---------------- �j Q Type of Building Size Lot...____ ._. 1! Sq. feet U Dwelling—No. of Bedrooms--.-_----- --------------------Expansion Attic ( ) Garbage Grinder ( ) a4 Other—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Q' Oth W Design Flow.. .....~--------_-----------gal1Ns per person per day. Total daily flow--------------------------------------------gallons. WSeptic Tank—Liquid ca itv----------_gal s Length---------------- Width-------......... Diameter-------.-------- Depth....-_-----_..,_ x Disposal Trench—No - ......... li____________________ Total Length_.._.____-______._.. Total leaching area--------------------sq. ft. Seepage Pit No_____________________ Dia eter-------------------- Depth below inlet.................... Total leaching area------------------sq. ft. z Other Distribution 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.----------------------- 4q Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------ - - - ---- - O Description of Soil---- -_ ..... ___. .... 1�a x -------•-----------•-•-----------•-------- -------- -- ------------------------- V ..--------------•---.....__.....-----------------------•--------•--••---•----•----•--••-••••-•--•-----•.............•---•----•------------•-......_.......--•-------------------•-•---.......----------- W -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable---------------------------------------------------------------.------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------- •-•-•-•--------•---------------------------------------•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage D- posal System in accordance with the provisions of Article XI of the State Sanitary Co e— Th dersigned furt agrees no to�l the system in operation until a Certificate of Compliance has bee ss ed e board ea G/ Signed--- -- - - ---- •-----•-•---- -•- Z .� _ - Da a r-� Application Approved By------ -• • -----••--- .-• ......t- -• ---- — - - ------ e Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------------- --•-•------------------------------------------------------------------ /7 v j Date PermitNo......................................................... Issued..... 7 Date WO ' . No. �1,r_lf. ` Fix ..L...... r THE COMMONWEALTH OF MASSACHUSE TS BOARD F H E .......... OF. .. .... ... ... .. ..................... ,�410liration -for Bwvoiittl orkii T iitrnrtion Permit Application is hereby made for a Permit to Construct o Repair ( ) an Individual Sewage Disposal System at • • ��--- .--•--•----•- • ......... ........................... ti s, or Lot No. �. Ow'er Address ------•--• -.1.. Installer Address d Type of Building ` a r+� Size Lot__. _. -Sq. feet U Dwelling No. of Bedrooms--.--.......................................�" "". Ex ansion Attic Garbage Grinder aOther—Type of Building ---------------------------- No. of persons__---__---_______-_.-__--_- Showers ( ) — Cafeteria ( ) Q' Otl u W Design Flow__ _______________________________________gallo s per person per day. Total daily flow-__--_-----:------ ___________------.....gallons. WSeptic Tank—Liquid ca ` i v_._ ..._.ga s Length---------------t Width------- ........ Diameter_-----_- Depth................ x Disposal Trench—Noll _____________ It..................... Total'Length:----____-__-._-_--- Total leaching area-__----._.---.--__-sq. ft. Seepage Pit No--------------------- Di a eter-------------------- Depth below inlet-------------------- Total leaching area-.-_-.--_-----__-sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------------- ---------------------------•-------------------------------- Date......................................... a Test Pit No. 1-----_----------minutes per inch Depth of Test Pit-.____---_-_..____._ Depth to ground water------------------------ rXq Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------ ------------------------------ D Description of Soil... ------------ --------_W_ -- --------------------------------------------- ...... ----------------------------- x --------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------- W ---------------------------------------------- -------------------------------------------=---------------------------------------------------------------------------------- ........................ U Nature of Repairs or Alterations Answer when applicable..---------------------------------------------------------------------------_-.-.----_--_-- a ------•--•-------------•---------------------------•-----•-----------------•-----•------z•------------------------•----•-----------------------------------•------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage D• posal System in accordance with the provisions of Article XI of the State Sanitary operation until a Certificate of Compliance has be C e—Th dersigne fur,- agrees n to lacce}the system i /�► iss ed e boar e SiZned:_. --- r D e Application Approved BY------ --•--- . ... .... ... Date Application Disapproved for the following"reasons:----••---------•-- = ---------------------------------------------------------------------------------------------------------.-----.-___---.-----__------_--_____-___-__------- ----------------.______-._-_--__________--- Date Permit No........................................................ Issued--- Da__ 4 E COMMONWEALTH OF MASSACHUSETTS BOARD �.....................O F. ..:..........................:............................... THPIOrrtifiral a of Toumpfialta THI S TO- ERTI Tha ndivid 1 w Disposal System constructed ( or R aired ( ) by..- = Install at ---- - ------ --• .-- _-- - -- -- has been installed in accordance with the provisions of Article XI of The State anitary Code as described in the application for Disposal Works Construction Permit No..................:...................... dated-.-._---_-_----_---_-___--.--- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A Gl<J RANTEE THAT THE SYSTEM WILL UNCT N S TISF TORY. ................ < DATE = Inspector COMMONWEALTH OF MASSACHUS TTS ► BOARD F .HE ... ... ..O F ---.............................. No.... FE»........................ �i��>Q�ttl x�rk,� Cnon�fxnrtioat �rrmit - ��"�_ Peris hereby.,granted----------------------------------------------- --_-.-.-------------•-••----------- ....................... --------------••---•-•- to Construct ( o pail ( ) n Indivi al Sewage Dt �+dl Sys * , as shown on theeaicat' for Disposal Works Constructio sit Dated_.. _ ---------- ---Board of He DATE FORM 1 5 HOBBS & WARREN. INC.. PUBLISHERS f