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Home My WebLink About0012 PUTTER LANE - Health (4) tauIS 9,L@1 - �'Q-- t%,63Y No.---y--.7�y .� ,... Fps /5.................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Tom. ------OF... ATZNT '131� ... .._------........ Appliration -for Uiipusal Worko Totuarurtion Vrrmft i Application is hereby'made for a Permit to Construct (�') or Repair ( ) an Individual Sewage Disposal System at: ----....�-r--�•------•�t� TT �-- --------------•----- - 6- ............................................... `�Leoc�atio�nn-Add ss �\.� or Lot No. Owner Address ......... ...........c-►�,so �tZ. ------------------------------------- ............................St--P,b.L.e------------------------------------------------ Installer Address UType of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms................ ------------------------Expansion Attic ( ) Garbage Grinder ( ) a4 Other—Type of Building ._......................... No. of persons---------6............... Showers ( ) — Cafeteria (` ) Q' Other fixtures -•------ --------------•------ W Design Flow______________S.�.._.._-__-.___..._.__-_gallons per person per day. Total daily flow------------- Jd____-_---...._..gallons. WSeptic Tank—Liquid capacity1�C?gallons Length-----�"...... Width..S.....:_.. Diameter................ Depth------------._. x Disposal Trench No. .................... Width-------------------- Total Length-.-.--_--_--._..---- Total leaching area--------------------sq. ft. Seepage Pit No..................... Diameter-------------------- Depth belo inlet-------------------- Tot 1 leaching area.--_-_-_..._.-__-sq. ft. Z Other Distribution box (i/� Dosing tank ( ) v;, 00.•y. Nlr�hrf)_'f , ,- x z-71. �-' Percolation Test Results Performed by-------------------------------------------------------------------------- Date....._..----------------------------.... a ,a Test Pit No. 1.......2-.....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.......-___.__._-....___ P' ------------- --------------•-----•--------------- ----------------..............................--i-----------------------------------------------......- 0 Description of Soil-- O .-l`Z" ~oi M----I----a'! `��....IAJeD... �4Rt4,z..�---Ge *;_---------------------------- �' �y�' q �'1. D �.�A1,� a q cQ 5 to" M = -NE SgLN� U W ----------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- 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 Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee ' sued by the board of ealth. Signed ---/ ------------------------------------ ----------------------------•--- �i Date Application Approved By----- � a�J---� - ... -------------- <=NI/ Date Application Disapproved for the following reasons-------------------------••------•--------------•-------•----------------•-------•-----•--•-----•---•-•-------- --••--•-•--------•-----•------------------•--•---•--••--------------•--••-------------------------------------------------------------------------------------------------------------------------------- �,/ / Date Permit No......................................................... Issued......... 1--` 7�-------- Date No......................... — .�. FE$.......5......... ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..... ...... .. � �. :. ' ........... ...:............... Appliration -for Bhipasal Workii Tutu trnrtiun Vrrm t Application is hereby`made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: ' "':_a__:ttY ......_�5 ..................... -.. " :."J{ l as y Location- Add ess r a or It No _ •------•--•-----••••-••----•-------• ------..---+,I ......................................... Ow.cr Address a ................................A � .................................... .......... .........................................------- Installer Address UType of Building Size Lot____________________________Sq. feet .,. Dwelling—No. of Bedrooms_______________ ________________________Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building ............................ No. of eI sons________ . ______ Showers — A., YP gpersons. --------- ( ) Cafeteria ( ) dOther fixtures ..................................... W Design Flow-------------- '�-__-_•__--__.............gallons per person per day. Total daily flow------------�,3 ....................gallons. Septic Tank—Liquid capacitytS�r:'°' _gallons Length-_•--- _______ Width_t .__..__ Diameter________________ Deptll..--_.-- xDisposal 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 (V�, Dosing tank 7/ - - //_ 2 z- �7. aPercolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------------------- a Test Pit No. 1...... -____minutes per inch Depth of Test Pit____________________ Depth to ground water.-__---_____-_._---- f1 Test Pit No. 2----------------minutes per inch Depth of Test Pit____________________ Depth to ground water---------------__-__--- �. � " + --�--t-; 1 w�.'< � .�+a i iC �'^�l s € C t- Description of Soil W V 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 Article XI of the State Sanitary Code-The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee sued by the board of- ealth. Signed... -`[., -�� f ------------------------------ Date Application Approved By--------- ( ._. f"12_ tom- ----------------------------------•. -- 7-7----------- �� Date APPlication Disapproved for the following reasons:----•-----------•--•----------•----•--------•--•------------------•--•-•-•-----------------•------------...... -------------------------•---•------------•---•-----••--------------•--------•--------------------------•-•--------•---------------------------------- --••-------------------- ........................ Date PermitNo..--•-....•----•-••----•---•......................................................... Issued...................... ................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .'� f .: :..�..... OF.... 3t . ...... .----- .wTrrtifiratr of Tomphaurr THIS IS TO CERTIFY,'That.the Individual Sewage Disposal`System constructed ( - or Repaired ( ) b :T!DX_A:t� .. �i �' ••----------• •--/ ----------•- --•• -- Inst.11er at...............`b-Q=• 5-- - ,� 1• c4?X?'t.-- )11 �r-----/ f------------------------------•--- has been installed in accordance with the provisions 'of A-ttcle XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No- -- -_. .-__-_:__ ............. 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 ? OF.-.. ...... ........................... No......................... FEE........................ Bi-spafitt1 Workii Tow5trnrtion Vrrmit Permission is ereby granted ) _ S 4 1 �? -------- '1.?.-b • +' to Construct ( or Repair ( ) an Individual Sewage Disposal System t 1 w } j ' i # l.. -------�-h) . tj.`1.__a91r.�.L r..i`-- ....r.........._ Street 1_j --�J- 2 {� 27 as shown on the application for Disposal Works Construction Permit N�o.--_----_-_----_ Dated--- -.-_-._---------------------------- DATE. I�• ��----------------------------------------• Board of Heal � ---------------------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS j a • - __.__-.._.._, .. ��0 53.�8 - 18t� TEST. HOLES L0T LoT 3 ,tl. N / 7 7 bov& MC.[NTYRE INSPECTOR 10 act+1 EL5V TEST a oZ. 6 Di ST RESERVE y LEACH /aZ a a?�I MEDIUM 25t+b io' SEPT/C TEST . ., TAuPc Now 1 24 :t9t4 2gto 23�')to` 2330 N a 5141`�E7 PROP -` LC7 �' ! ! 2g' L43T 4 96 -!5'6 Me1?/t1/V -3 $bRN r- Qo.+ t HOUSE. g3 u _ ELEv 9..6 a cq '. No WATER ENCOUNTEPED a /DO.00 - y P U T T E � ToLJTd WATER /S AVIi/�.R ac F 40 ( \ //D,E` ' 4U �'' F2OiV T "S'i z�E• ..� TZ�4T� P;eo no 5� . ` � BE.,D1200MS SEPTIC 5y57EM CoiV.5-re UCT/ON ' SHALL. GONi'02M TO MA55: >; DESrGiV FLOt�t/ �Q GAL�17,4y EN✓/2OrvM�A/Z.4G: COOS. Tir[..:� ]!' -��• E V/ 5 E U '7-/ 7 r �� 5" L G,� G, 2;�4 TE. G M�iv //t/Ch/l� P,2oPo5�DFQ'a L �91 -q;24 04)� /s h'OP OF /HEALT.y �2�Gu[..a1 TiC9NS 1 F�20%dOS:Ei a L EACAI �la,6 !. - �GD a .Foun/OAT/ON ` - . .- . 2•' o� P�q ST UNS' 26. 0 /M.p�Q✓/OUS CO VE/Z MAn1.l10LE �COS✓E� 7`O EX TEi�lD '7"'O 1/1//Tf//IV 1' OF Fl/�//cS�LGDr.G+ AO .c20/-1 /A/F/LT2AT//ll6 4 _ :1 6oX f z/ rv,Ac o ,,s,z Mum �P4'/�FNOO T -F-d-O—tX— fE 2. . i4w`pirc...y /O,LLgCAVTO M/ �1!O" ^ � �f2.q/.v D1A. P _Y_ A9itil WAS NEO 1 .000 _r_ hvvE.er /,8 / / ST-OA/E ' GA L L On[ /^l VF--2T AFL VE.eT CA AP-A TY AR0Un/O SE pT/G TA/,/•e � 2 2- CWA TG ra 7'16,Y � B oTl�l o� . �!1l VEZ7 ( � f' /,V VE�ZT NO GAR5A6E .G,2/J DES iv 1z; ILA f- 2 EFE 2 E:nlC� ,• _ BEN /N PLAN L / .sER"7lC TAAJ.�, a1ST.e/avT/ON BOx �$ O'LTLETs) A�AiD L. -E,4CN/.vG P/T FO,e TOE �F QEiA/FQ.2CED CaNCTGETE y L } COA1G'.2E TE ST5e,-_A 57, 3000 �/ M/N. - -ROBE T A D�. F E- STEEL 20000 .y ';�,/"' ;t' - - ?`.��' /-/- /O LOADING 13 � D�2/VE WAY NOT TO E3E LOCATED t3'O y' ,'/'. 1 '; �,�r;�.i t- '.;, ? ! . ,.::� _' 3 � --- ��;y.�, O V E�2 5`�'S TE M (JNL E 5 5 f/- 20 Z7�SI&AJ LOAD/&IO /5 us,5�. Ill L\ !],GA TE AlEAL774 ,4G4=_-v7_