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Home My WebLink About0051 HAMBLIN'S HAYWAY - Health ,S1 �vo-(YNOW u� o-3 C)- 02LA - i ASSESSOR'S MAP N0.630 k, 4 .PARCEL LOCATION SEWAGE PERMIT NO. 81 14%4vK)2 tv w cl--Z t 4) VILLAGE VA I N S T A LLER'S NAME & ADDRESS C—%4 f C 1oN4c,L,p .S M& P`OL 66> qq6 (11` V %�) B U I L D E R OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED ��,,� Y t �4 ISk25T(hrs o W o V >t N4-ST I-ft- 1twwrG .'pF7- cu1�'siQ Qv �l-- =7�c7 F .� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliratiun for Dispuuttl arks Tonshvdiun TIrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( Ly.an Individual Sewage Disposal tem sync -" •-------------- •-•--.....--- �_:Y.)n.�.1. .... ---------------..... r. » Locatio Address or LotNo. - -- » »..»».._��» v �.........0 ..jto �.................•-----..... -----•---•--•-•---.. - .... ........--•.»» ner ....»» ow .................................... ---Add - ....-- W ..................�°!! `-LAI.-JAY.- J.--• �''P- .��- ,_W............ ...................pk�s....00:�-� Installer i� �E^ ^lc�'! »?!l' ( a --Address Type of Buildin Size Lot................g •------•---.Sq. feet Dwelling—No. of Bedrooms...... ................................Expansion Attic ( ) Garbage Grinder. ( ) Other—Type T e of Building ................ No. of ersons.._......._..._......_...... Showers — Cafeteria a YP g ............. P ( ) ( ) a' Other fixtyres -----------------------•-----------..__._...._a .......................... --•---...............•••••--•-••-................---•--•.....---... W Design Flow..........7------------------------- .......gallons per person per day. Total daily flow....3.34..........................gallons. WSeptic Tank—Liquid ca.pacity............gallons Length................ Width...............: Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area...................sq. ft. 3 Seepage Pit No........I............ Diameter....1.0 t....... Depth below inlet....L--,)�.......... Total leaching area..................sq. ft. Z Other Distribution box ( ) . Dosing tank ( ) Percolation Test Results Performed by.......:......................:........•------.---........................ Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ x ..............•---- -----•-•--••-----•••----...--•-•--•-••---.............. -- ------.---.---......... --------------- -----..--.. 0 Description of Soil....----•-•.....................••-•--•------•-------.......-•-•----•------•-----•--•-------...-------•-•--.......-----•---.....--•--------......---.........------..... W V ------------------------- •--------- ---------------------------------- .... ---------- •--------------- •--------•----• ----•-- ----------------------- ----------- .--.-------•------- W UNature of Repairs or Alterations—Answer when applicable.....__ .�........i9.mtl�n.._..(a I ....... ...-----4b. �G.._ ' _� _ .......... .......... _�.Situ- -------------------------- Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL U 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b the board of health. Signed_..:..... -- . -- --- _... -. ••---- .......... .. A- = t�� Application Approved By............ ..•••---...: ..... -_-•-- f ' ---_------------------•_ ----------. ......_.........._ Date Application Disapproved for the following reasons:.......................................................................................................... »..» Date Permit No.............. �1 ©.......» Issued. 7 Date._. .........» ...... THE COMMONWEALTH OF MASSACHUSETTS _ _--- BOARD OF HEALTH ttc{z�l — rav—,-I�- OF .........�....A WSA.SA_�.O ........................... - Appliration for Disposal Works Tonshvdion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( L),an Individual Sewage Disposal System at: AKI\_�1,. -_ . ��:. �-�............... .............. -....._..._.............--_... .... _.... —I:ocation•Address I- -or Lot No. ._..-•-••-•--.......--•--•. ---•••--._...._...-ate'-'4•a=`�'o -.... ..........._........_......- - ........... ....-.. OwnerAddress a c �__lwal .. �� ::•••--•------ ..................D,�o.:...CSc� -�� A/1�:..! '�.:� • -._....._... ....... ... Installer ,_ , Address Type of Building Size Lot............................Sq. feet a Dwelling—No. of-Bedrooms.__.....�.................:..............Expansion Attic ( ) Garbage Grinder ( ) �;f p, Other—Type of B�u41di4�g 4a........:...............' No. of persons....................... Showers ( ) — Cafeteria ,( ) aOther fix res -•.......................................____-•--------- '.............................. W Design Flow........_'�?___.__�.. .......................gallons per person per day. Total daily.flow.._. :C ..........................gallons. W Septic Tank—Liquid capacity_ ..__.__.gallons Length................ Width............ I Diameter................ Depth................ x Disposal Trench—No.................:... Width.................... Total Length....................``Total leaching area...................sq. ft. 3 Seepage Pit No........I............ Diameter.....t ....... Depth below inlet___._ln�.......... Total leaching area..................sq. ft: Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed bY........................ ............c..................................... Date........................................ Test Pit No. I...... ........mtnutes�,per inch Depth of Test Pit.................... Depth to ground water........................ LL, Test Pit No. 2............:...minutes per inch Depth of Test Pit.................... Depth to ground water........................ OG _......-----•--,--• ____._._.••• .................:........................................................... ODescription of Soil...............!..................t._____:___..._.___._______....__---__.......-----------•------...................................................................... 4 W ---------- ___•--------- --- ------- ? ----•- -•-•----------.__._.._..-•-•• ---------- :•-- •---------- --.._......---..._ ••---••------_.....---•--.__._._..........._-••...__...-- U Nature of Repairs or Alterations 'Answer when applicable_____-1--wSTva .�-__._..- v- -•-,-(pry-fOr•.i-_......_. Agreement: The undersigned agrees'to •install the�aforedescribed Individual Sewage Disposal System in accordance with T ,, the provisions of TIT LE 5 of the State Sanitary Code=The undersigned,further agrees not to place the system in operation until a Certificate of Compliance has:been,issued b"the board'-of health } { ±._ Al Signed Date Q r .AP lication Approved ........... —... 7....��' 7 .. Date Application Disapproved,for the following reasons:.......................................................................................................... •••••-•••--••••••••...-•••••••----•--•..........................•--••-•--•----="_________.....---------•--________.._........._.._._.....____..--•-••---------------..........._•------_._____________ Date * Permit No......................... Issued............. 7 /S 1 r, j Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH •.�•�1.�-.�!.'.-.....OF.7T�V::S a �S't12.�-� ;...................... farrtifirair of Trrntpliinrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System-constructed ( ) or Repaired bY....................1�4a .>~! w - ``' t � . ......................................................_. ..........._.._......-----....- 1 1 Installer at-------•---••---- `�-� - .WMtiY)��.!! -----•14 ER tud... T � �.f Q. ...__. dated......... ... -.J. ./ � has been installed in accordance with the provisions of TIME E 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.Z _______________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE s `SYSTEM WILL FU �C'TIONN SATISFACTORY. -1 DATE Ins ectoi f { '. )Z .......... i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTHY �—�' �l """'�(��!L!..V`- .....OF .Y ! [tiS` �4Y-- ............................ No; _l............ FFx............. ......... Disposal Works Tonstrttrtion prrmit Permission is hereby granted.......... l-:_uk! .••... a✓�T.!?.''............................................................. to Construct ( ) or Repair (4.)--an—Individual Sewage Disposal System ` I at No._ ... `�� • _E L:a_.........TWA . -�.�.... ..............!l 4___ a. .................. ............... Street C as shown on the application for Disposal Works Construction Permit No._....._._�.?_ _._/Dated.______��_.�1.................... .......... ............................................ _ _ �� j € /y Uoard of Health DATE.......... '