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Home My WebLink About0061 SAINT JOSEPH STREET - Health (2) Se�l— w No......0............. Flz$.... a........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _./AW 17OF.......... e....------.. Appliratiun -fur Disposal Works Cnnnitxnrtion Vantit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: t'oca -A dr or Lot No. --------------� Qllj. Q -- ................................. --------��e�s' y lz�'!� z' ---------------------- wn A / Address •-- I---•--- .-, D...........1 ---•--•-----------................................ Installe-r T Address UType of Building Size Lot_.1_).J6.9-_9-........Sq. feet �-, Dwelling—No. of Bedrooms__________ ______________________________Expansion Attic ( ) Gar age Grinder ( ) aOther—Type of Building ____________________________ No. of persons.-.------ Showers ( — Cafeteria ( ) a Other fixtures----------------------------------------------------------------------------------------------------------------------------------------------------- W Design Flow--________-�S SP.......................... per person per day. Total daily flow......... Qp-----------------------gallons. WSeptic Tank—Liquid capacity_bO.O.gallons Length................ Width---------------- Diameter-------.-------- Depth-----_---------- x Disposal Trench—No..................... Width__----------_------- Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No........I----------- Diameter-------- Depth below inlet____---Cc,�........ Total leaching area__ dsq. it. Z Other Distribution box ( ) Dosing tank Percolation Test Results Performed by on_C_.1. _..L-a-4.a-V bp^.__Pk ..... Date... ry_A_.....A-1]_3 aTest Pit No. 1.....!7r.2-__minutes per inch Depth of "Pest Pit......l.Ca------ Depth to ground water...'N.O1-4.IF---- fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-_.__-________-_____---- ----•----------------------------------•-------------------••-......-•-••••.................................................... Description of Soil------- -- Inc .see-_ 11 w4k ------am..ce-r------- 1_ lsL K n -Yvi�4_y �C- L V ----------------------=-----------------------------...............................................------------------------------------------------------------------.....................-------------- 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 \I of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b n issue by the board of health. Signed---- s G•----------------•---------------------- I Date ApplicationApproved By----------- -------------.................................................................... ---------------------------------------- ate Application Disap�,oved for the following reasons:-�--------------------------------------------------------------------------------------------------------•-- -••-•----------------•-----------------------------------------------------•-•---------•••......---------••-------------------------------------------------------------------------------- ------------ Date :..Permit No........................................••-•-•----------- Issued....................------- ............................ Date 1 No......ed - F��..... :... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....._7awe?... '- -- .OF.......... rr/o. Gz-4.k................................... AjiVfirtttiun -fur Diupuottl Workii Tomitrurtion Vrrtnit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: , Location A r s or Lot No. ------ wne �• f Address ----------- ---- '"Z- ------------------------ Installer Address QType of Building Size Lot... .►;_3 .'�____-____Sq. feet U g— .___.Expansion Attic ( ) Garbage Grinder ( ) Dwelling No. of Bedrooms...____._.__ _________________________ PL, Other—T e of Building No. .of persons.........Ea................ Showers — Cafeteria a' Other fixtures __--•------------------------------------------------- W Design Flow----______.- __________________________gallons per person per day. Total daily flow......... _.__...................gallons. M Septic Tank—Liquid capacity--DOD—gallons Length---------------- Width------.......... Diameter-----:.......... Depth.-..__-__-._---- x Disposal Trench—No_____________________ Width.................... Total Length_-_____._.______._.. Total leaching area--------------------sq. ft. Seepage Pit No:_______R----------- Diameter-------- Depth below inlet....... ......... Total leacling area___ �„ C?sq. ft. Z Other Distribution box ( . ) Dostn tank ( ) Percolation Test Results Performed by -------+ s---- _____ Date___ _ °_►. .__ _ aTest Pit No: � _1-____' _ _minutes per inch Depth of Test Pit.-._-_1_ ______.Depth to ground water---- f14 Test Pit No. 2.................minutes per inch Depth of Test Pit-------------------- Depth to ground water-----------........ ._.._ a -------------------------------------------------------------------------------------------------------------------, O Description of SOB--------+ ? "= ------ --- . -- 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 XI of the State Sanitary Code.—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b�en issued by the board of health. Signed i 9Wa t $------------------------------------- ' --Date , Application Approved B Date Application Disapproved for the following reasons:_____________________:___ _____________________ w 1 Date PermitNo. ......................................... Issued........................................................ Date • a a , THE COMMONWEALTH OF"MASSACHUSETTS BOARD OF HEALTH .........OF......... - A�....... 01rrtifirntr of nut litturr THIS IS TO C f RTIFY,T at the Individual ew ge osal tem constructed ( '°f or Repaired'( ) by �� - - -----------------•- .................... C /jInstalle - has been installed in accordance with re provisi ns of Article X of The S tfte Slnitar Code as desc abed m the 6 j application for Disposal Works Construction Permit No-------- ................ dated------------ w .......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUAR ANTEE.THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATI✓- ------------ -------------------- Inspector .------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............. No. FEE '- RsVwial Morkii (nonotrurtion r ' t Permission is h eby granted.............. ----- -- -- --- -- :_.. _. 't�. to Construct ("- or„•R.Spair ( ; n Individual Sew ge Disposal Sy to ' >•.—------- -----------••-•- Street i r ' ' as shown on the application for Disposal Works Construction P r No._: _ +__________ w�ated _ ............ +DATE...... ------�- --------� -------------------------------- Board of Health FORM 1255 HOBBS & WARREN. INC., PUBLISHERS DOWA L 0 ✓. MA R rEN REG/STEREO 'PROFESS/OVAL:. ENGINEER ' i P O BOX /4 PLYA40UTH /19ASS 02J60 r r IN:OF/yAss�� 746-.275.3iq: if x DONALD J. TOWN_:. OF , 9,410 MARTEN Ln PROPOSED SEt�YERAGE SY'S TEm LOT 1 Crown to d/vart surface water v Cover at grade Pe�co/ot/on rota ' — 2 min. per , rr �� Back fill ��—'�• T 2,,,Peostone I� � , ' p00 o 00 p � � o • � n I c C v nearest pit to we// nearest we// to pit 6Xgt,.P I i ! , 'i �i t 1 � P _a FT f 6 C)eCkn Sc+MQ i .Stole' 34/ t No water 1 i 'i