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Home My WebLink About0031 SAINT JOSEPH STREET - Health (2) � l �-e.� 3 ' rJ .A, No...1 ----.---.--. 2q 1 — 2.1 (p THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 3 of...... �RNs£" ��1 .........................------------- AppIiratiun -fur Ubipniittl Workii Tonstrnrttnn Vrr mft S� Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .......... r--(1,044,?/'-� ............................ ......... ........ Location-Address or Lot o. Owner -• a�"o� Address ,� � stal er Address UType of Building Size Lot--.-_It3}.I.1'3._....Sq. feet Dwelling—No. of Bedrooms.-._--__�3--------------------------------Expansion Attic ( ) Garb ge Grinder ( ) Other—Type of Building a g ............................ No. of persons...._._Fs----------------- Showers ( — Cafeteria ( ) d Other fixtures --------- W Design Flow......_____525..__.•...................gallons per person per day. Total daily flow........3®-®--___________-.---.-..gallons. WSeptic Tank—Liquid capacity_10b4_gallons Length---------------- Width................ Diameter---------------- Depth_----_-------- x Disposal Trench—No--------------------- Width.................... Total Length------------.------- Total leaching area--------------------sq. ft. Seepage Pit No.......I............ Diameter--------13....... Depth below inlet......6.......... Total leaching area--_2._�_-sq. ft. z Other Distribution box ( ) Dosing tank A W Percolation Test Results Performed by---- c _ .5:._.�.._.!`"�__ .r_F_S'a_t�._. :L_L Date...PV -- Test Pit No. 1____—_Z--minutes per inch Depth of Test Pit......10--____-- Depth to ground water._1AQ_%.L...... f� Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water--..-.--_---___-___----. •----....--•---------------•-----•--••-----•--------------•-----------•--••-•------------------••--•-•--•--•-••--------•-•••--•--------------------•--••---- Description of Soil_ --.14V.MVi----VMA.R-.- _-C_L_VAA_L_5_t4N_fJ ..... _"►t4LL----- -t°-rt- ------------------ x W UNature 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 been 'ssued b he board of health. Signed........ k-------------------------------- ---tl g.. Date ApplicationApproved BY................................................................................................... ------------ ------- ----------------- Date Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------------- -------••---••---••-------•-•---•-•--•-•------------•---•-•----•-----•----••--••----•-••-----•••-•-•-----•-----•--•-------------•-•-•-•-•---- ------------------------------------------------------- Date PermitNo......................................................... Issued........................................................ Date No..........14-.�...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ........ `o.W,ry ...........of...... , .# ......... Application-for 43iipoottl Workii Tonotrurtion Vrrntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ............ en �'-------------------------- Locatiioo+n-Address or Lot No. -------------------- t •�P S.lii{ s _ ` .Y6p a4 t A1�-ra:lqe_-�p-�-'�---...-•--------------------•-•-•-••---......... - Owner l Address ....................`-`"--------•- ---.err----- --�.... - -�"`••---=_,6kkE!✓JCa1!Art<.........-.-_ .......--•--•......------•-------------•-•-. � stal Addrreses s s Type of Building Size Lot.....I_ �_.'_ .......Sq. feet Dwelling—No. of Bedrooms........ ................................Expansion,Attic ( ) Garbage Grinder ( ) Other—Type T e of Building a, yP g -----------------------•---- No. of persons--------- ----------------- Showers ( — Cafeteria ( ) aOther fixtures ....... .............................................. w Design Flow------------SO.........................gallons per person per day. Total daily flow...... Z.Cr-sue________...._._........gallons. WSeptic Tank—Liquid capacity_1 a0_gallons Length---------------- Width_.___._-.___. Diameter---------------- Depth__.---------- x Disposal Trench—No-•________________•_- Width-------------------- Total Length----------------- Total leaching area_..._.___-__._______sq. ft. 3 Seepage Pit No-------t------------ Diameter.......... Depth below inlet......6__...._.... Total leaching area--- „_ _c'�__sq. ft. z Other Distribution box ( ) Dosing tank ( ) d Percolation Test Results Performed by---- a. _C.,tI_ _. ---R(L._ Date... Test Pit No. 1.... __t. 1...0.minutes per inch Depth of Test Pit_.____ .....__. Depth to ground water...0 0.a.tw------ �14 Test Pit No. 2-_•_-•__•••-___ - - per inch Depth of Test Pit____________________ Depth to ground water_-._..-.._____-_.__-__.. --------------------------------•--------------------------------------------------------•-•---------------------------.....---- ....................... D Descri tionof Soil_ = A,1 [ ...!_ 1} 11 ____�E ,____._ ` _@ .__ _+��!..-__• �_-•_• -a ?A_ _ ►�t_5 ------------------ x P 9 _ �t------° -- U --------------------------------------------=----------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------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 beer4issued byrthee board of health. Signed.........--_"J ._ �t _s--...Z L a------------------------------- a'.! i Date ApplicationApproved By------ -----------------------------------------------•-----------..........•--•-•--•-•-•-••---- --•---•---•-----•--• ---- ------------- Date Application Disapproved for the following reasons:-----------•------------------------------------------------------------------------•------------••-•......----- •--------•-------------•-------------------------------------•-----•...----------------------•-•-•------- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH I �. ...OF...... ............................ (ETrrtif irnV of fP�outphatta THIS IS TO CERTIFY, That the Individual a ag sposal = stem constructed (.. 'or Repaired ( ) by ~. _. at0 - — •p `�+�.e£fe nsta � 4 .-----•-•------------•-•-..•----- J _-r,v •• - -- has been installed in accordance with the provisions of Article XI of The State Sanitary Code as drescribed in the application for Disposal Works Construction Permit No----- ,v-__--_•____•__________- - dated.....•. ___________________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT TIME SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------_----- -------------------------------------------••-•-•--------- Inspector..................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ St ............OF......, -------------------- No._, - ------------ FEE Biquo,ial Workii C11onitrnrtion nt;� Permission is reby granted_. r ' 4 tj................. to Construct ( ) or Repair ( an Individual Sewage Disposal System Street f/ as shown on the application for Disposal Works Construction P t N, ile_ _. _ Dated_. ' ................. _.._ •- 'SA"�-'�--"-- ------------------ r BoarHealth DATE.--- ... -------------------------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS I . DOMALD J. IWARrEN REalsrEREo PROFESSIONAL ENGINEER I P. 0. Box /4 PLrasourN, MASS oz.360 ►� OF � 9 r 746- 27SS F DONALD J. rn TO GYN _. OFT ..L .�:� o. MARTEN PROPOSED sL wERAGE sys r M ' 0 90 CISTSfx��c``� FSS�ONAL��6 I �k .Crown to d/veN surface wator _Cover of grade Perco/otion, rote 2 min. peg '- 2��'Peosfone f I o v -J-. 0 op /2 tony bb v nearest pit to we// I nearest well to pit aso/t 6x8 �- 1004 C,til.S,T, �,SI Sa oI «YrnuS , , o ! , k'a 1 . I Use U r Scalekv t 0 water