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Home My WebLink About0019 REDWOOD LANE - Health i9 �d�ood (,�.ne �c1. � }. ,s i i i i i No .......... --.._ FEaA-3........._ THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH . . . `-....oF...............::................... . ............................................. Appliratiun for %puuttl Works Cgunstrur#iun Fermi# Application is hereby made for a Permit to Construct ( ) ;or Repair ( ) an Individual Sewage Disposal System at tion-A d ess / $ ro» o. ........... . .-_� ................................................ N - •— . ........ .... s - ---- dr s < --- ... .. __ .. .- --- Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building ____________________________ No. of perso __._._ns______....____....._._ Showers a ( ) — Cafeteria ( ) 04 Other fixtures ..._... W Design Flow..:.................:.......................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................. Diameter................ Depth................ Disposal 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 ( ' ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date.:...................................... 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........................ a = --• •- ••...__---..._••.............•......--•... 0 Description of Soil______________________ ........... ............................................... ....... ........................•------•------------•---------------....---•-•------......-•------------•--•---•.._._._._..._.. x U ...............•------•-•-•••--•------•...------••-•----•--•--------••---•---•......_...----•••---•••...._..-••••••-•----•--••-•-.._..-•------•-•---•••••----••...•-•------........_.._....--•-•-•••_.._. W •--•-----•••-----------=-•-••...••••. ••=••------••••-••-•-...•••---•-•-•--••----•-•-•----••--•••--- = U Nature of epalrs or Alteratiolis—An er when applicable-_._-__ _ ....I-h1_Aq__ ..........------------!�-..... Agree The undersigned agrees to install the aforedescribed �ndiv�idualwage Disposal System in accordance with the provisions of.TIT?, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate'of Compliance has been iss d by the board of 1 ealth. d ��. _ ....... — y � •_ .... ate_ Application Approved By___________________ J/ ® Date r Application Disapproved for the following reasons:................................................................................................................ .............................................................•-------._........--•---=----...------........--=------......--------...__.---------._..._..:--------•-----•-••-•---•••-----....----•••--_.. Date PermitNo.... .... . ....... -------------- Issued....................................................... Date No . FEE THE COMMONWEALTH OF MASSACHUSETTS -BOARD F HEALTH .................. .................... ..................................................................................... Appliration for Disposal Murks Toustrurtion ramit Application is hereby made for a Permit to Construct or Repair an'lndividual Sewage Disposal Systim at _7- W 7"00 JAI" 19 .......... .......... ............... ........... -Lo� ............... ration-�A' es - F�wz:............................................................................. J7 I-s V Mdres ....... ........ C.i., Z...... L .................. Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder Other—Type of Building ..............................No. of persons............................ Showers Cafeteria aOther fixtures ................................... Design Flow............................................gallons per person per day. Total daily flow................. gallons. 1:4 Septic Tank—Liquid capacity.............gallons Length............._.. Width................ Diameter..._ Disposal Trench—No. .................... Width._..........._...... Total Length............._.._... Total leaching area......... .........S'-4. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.._..._:............ Total leaching area..................sq. ft. Other Distribution box ( ) Dosing tank ( ) , Percolation Test Results Performed by............. ....................................................... .... Date........................................ 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........................ ... ...... Description of Soil...................... ......................a.............................................................................................. 0 ....................................................................................................................... U ......................................................................................................................................................................................................... .................................................................. .................................................. • - I .....J1......I..... "';7----------- ...........:�j Nature of Repairs or Alterat�i�otis- An when applicable.....__ U t�'L�... ...... .............................. j!r w r�......., '1! 'j I - I�t-------:-.t............................... ...................L... 'i:;� P---------------- .................................;......... ee A - I I Agr m Fir The undersigneda 16i� agrees to, install the aforedescribe vidual Sewage Disposal System in accordance with he provisions of-'JI A't .TZ] 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss 0 by the board of 1jealth., '�a4A r. ......................................... ...... ............ V D Application Approved By....._ —.. ................ .......................... ...... Date Application Disapproved for the following reasons:................................................................................................................. ....................................................................................................................................................................................................... nau...... Permit No.... ......................... ............ Issued....................................... Date ———————————————————————--——— THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -7 , ...... -7 ................. ......... OF../..�4........................................................................ (Irdifiratr of Tompliatta THfS IS-T-O'CER,TII*tThaV the jndividua,l Sewage Disposal System constructed or Repaired 4 by ....................................................................................................... ......=4 . .. ........... Ai 7 Installe-0 A at.................... .................... V......................... .................................................................................... has been installed in accordance with the provisions of -TIL'-LZ 5- f e State Sanitary Cod"_ Vdescr!Ppd .7'n the Permit No--- --_g. application for Disposal Works Construction Perm YZ .... ...... dated..........S7/_.?,0.X� ............ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM. WILL FUNCTION SATISFACTORY. DATE....... Inspector........./n............................................................. ... ........ 7 -------------------------------1 k •---------------- -—————————————————_—————---—————————————————————-- —————— THE COMMONWEALTH OF MASSAC HUSETTS OkI BOARD OF -HEALTH 77 Z-441-� .............. ........................................... No ................ FEE... ........... Disposid VVykn ttslnul�ptt um tit . .......................A ....................... Permission is hereby granted---- ------_'W��...... 7.zr-----�** 11111'1111 ------------- to Construct w7 - epaip Q.),'an Individual S ;a Disposal ystem at No..._. , -- - I . .. .---- --- . I. ................................. Street as shown on the application for Disposal Works Construction. Permit No_____________________ Dated... ............. .....................wz=................................................................................ Board of Health DATE..........A.T.,.................. .............................. _z- NOE;