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Home My WebLink About0133 MOCKINGBIRD LANE - Health 1 OMockingbird Lane Marstons Mills ------ - -- --- __— --__ _ - A= 013 -021 0'== I r 2J�aEtYtvO�o�. UPC 12934 �4 No. 2153LY �,n HASTINGS, MN i L 0 C A T:I G-cze2 �� . � W`A E PE Q RMIT N . / + YI.LLACE r I N S T A LLER'S NAME i ADDRESS I d771- e U I L D E R D`A T E P ERMIT ISS,U'E D { DATE COMPcoj LIANCE . ISSUrD � a THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................OF.... 1�, --------------..----..-----.------------ Appliratiun for Diupuuttl Workii Tonutrurtiun Frrutit Application is hereby made for a Permit to Construct (V/ or Repair ( ) an Individual Sewage Disposal System at: �.... E-_.�: luu_b ...L"o .3................................ «_.l------....-----•.......... Location Address or Lot No. ...... Owner Address .IMOz �z caa ------------------------------ Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic (yee Garbage Grinder (N-0) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) WQ' Other fixtures ._.......-•-•--••--------•-•-•------•-----•----------•-•--••----•-•-••-•--•-••-•--•---•-•--•------------------------•---------.....•---..._.._.--••-- Design Flow..............................gallons per person iper��ay. Total daily f�4w_.._ _....____................gaon `, WSeptic Tank—Liquid capacity.t allons Lengthy............ Width._^.kb--- Diameter................ Depth..5-... x Disposal Trench—No. •:_--••--- Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..................... Diameter.............. Depth below inlet......j�� ......... Total leaching area. ---sq. ft. Z Other Distribution box ( Dosing tank (N,a) '-' Percolation Test Results Performed by.._ $111 t .. �._ �3 -1 .-•--.-----.---•-••-_-•--- Date.... �ka! aTest Pit No. 1_ ..c�_.__.minutesperinch Depth of Test Pit.....! ....... Depth to ground ..__.:.'._ �N ►2� Test Pit No. 2.Z_.a...minutes per inch Depth of Test Pit......L&.__-- Depth to ground water._M't_... �1 ��tr a --- ----...•-....--4C?-; �?.-- --- ----.-------------------------•--.......•----------------------------••------ ---------•-------- .--- G�- ._._... t vDescription of Soil..0=4-............................... 11� ...... ��.......T!t......-------'� -Ve .--------------•--......-•---------•--............. W -•-••••••••-------------------•--•--......-••-•-......-••--•------.-•------•---------•----•••-••••----••-----•••----•------••••----•••••---•••••--•-•-••-••-•••-•--•--•••-••-••............•--•-•...... UNature of Repairs or Alterations—Answer when applicable.........................................................:..................................... -•------•--•--------------•----•--•---•--•---...-----------------•......--------------•-------•--------------------------------------------•-••-----------------------------------••......•--•••......- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System.in accordance with the provisions of TITLE 5 of the State Sanitary Code The undersigned further agrees not to place the system in operation until a Certificate ompliance has been issrd by the board of health. Signed.. ............. w ......... . .. . .�� Applicat n Approved y........- ....... ............................... Date Application Disapproved for the following reasons:.............................................................................................................. ... .. — ..... Date PermitNo......................................................... Issued_....................................................... Date .�.�. ..... ... ,—..---------------------- No. zcx? F$a...::... .,... ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Cct .................oF.... 3Aa.1' -�........................................ Appliration for Disposal Works Tonstrurtion Prrnnit Application is hereby made for a Permit to Construct (V<or Repair ( ) an Individual Sewage Disposal System at: .�__..... (. .... ! .. '1 s .�:u _. '�: .......... ............._.......... Location Address or Lot N- Owner Address a tiY ► .. t :x�:�.? ' Cats._--.•----------------•-•••..... ' - a:.......- ._.:�� .l t:........... Installer •Address Type of Building Size Lot............................Sq. feet aDwelling—No. of Bedrooms.......................:....................Expansion Attic (yam Garbage Grinder (1►10) p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) aOther fixtures .....................................................................................................•-•--.......-:.....-•-•-• ...._.... d .......................... ' W Design Flow......•- gallons per person per 4 ay. Total daily gjw....�.ICI....................... s�,ti WSeptic Tank—Liquid capacity.) allons Length$:.`- !..... Width_k_."�Q.. Diameter.!"""..!"k... Depth..... ......... x Disposal Trench—No. i.......... Width l L.................... Totaength......._..........._ Total leaching area...................sq. ft. Seepage Pit No..................... Diameter.............. Depth below inlet......�!t........ Total leaching area..S 3 ..sq. ft. Z Other Distribution box D sin tank (qO) 1 Date....�. _ .............. Percolation Test Results Performed by.. E+V. .. -...T � -l^x. "5�: ..... a Test Pit No. I/...-a.....minutes per inch Depth of Test Pit.....!- Depth to ground water._..:dY___1_90_ ! C{2A2t% f=I Test Pit No. 2.!5....a...minutes per inch Depth of Test Pit......A...... Depth to ground water.A61...5914CWTM4 a 0 Description of Soil --------------------- ------------.....-.........._._.....---•--. • ------.........._...........------ e?--+ L2 Gl �1 'A -•-•-•-•-••-•--•-••--•••......-•................ t..."�,�i4xm$ -•••':.M...• t R ...... w ...--•-.....-••.........---••--------------••---•----•-------•------•---•-----------------•........---•---------•-----••---......--- -------------------•...... ......._. VNature 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 TITLE 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certifica a ompliance has been issrd by the board of health. Signed. .. Apph[cat n Approved y.._..- .. ........ ....... !L/t�sG Date .... Application Disapproved for the following reasons:.............................................................................................................._ -•-------------•------.........................-•----....----------•-......----------•--•---•------------.--..............-•-•••-••••....-•--•--•-•••••--•-.._......-•--••............................... Date Permit No........ � - '��- ------.. Issued.................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD F--.H.EALTH//�� ..........OF........ �`� "� C"�....... ,,...VV Tntif iratr of Toutphaurr THIS IS T�RTIFY That the Individual Sewage Disposal System constructed or Repaired - '� P �' ( ( ) by.............. .....5... :.....................0...... . . • ...... ..-•--•-........•..--............................................... ._...... Instal} at......... __0�.....ter.. _.__.. �-£. 1.-��,.A.....--r.............1 .�...--- --------------------------------------------- -has been installed in accordance with the provisions of TT of The State Sanitary Code a described in the application for Disposal Works Construction Permit No.....:8=.`_.z.................. dated...... ........... 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 2 Or�sy.........oF.............. ' No......................... -' ......... FEE............ .... Disposal Works Tonotrurtff VrrrAit Permission is hereby granted -! c �T'a�1 . .. to Construct ( or Repair ( ) an Individual Sewage Disposal System at No.. � .....lt ......M:.L-�.-c........................... • Street as shown on the application for Disposal Works Construction Permit No:.'=c; 'Dated... .... .l t.. ............... Board of Health. FORM 1255 A—M. SULKIN, INC.. BOSTON 78 ;i IS 77 ; ' G 5 �S � r __ t 4 r 's iJ Tip L;fz- 74 , , .� . . {a, '`1,. - '• r'��.'�;,� �f`-'��' .�^:...,G �`j _. 1 4 r'�3. �",»�3 G.��s,..- '•�`^�:.'°s{.` k�,(R,i ----- i r i i r i : r C # r f - e� a J 1 r, , w r -. 7 , y 2,'5 , ��C�TT: Sri' y .� _ ._..' .`�.»i'V 7t �'•� 76 , r. �+ GPI fzFi' BAYFORT HOMES, INC. 478 Route 6A P. 0.Box 80-East Sandwich,AAA 02537 (617)888-7799 IN .^.�?�`v%f'.� U� �Vr.��'"...'.. .., fe"��'4��t�"`tti i ,... ..._, �., ,. �.3�F"�.�`^:,.�`�r�°•.i�'�.`'+."...�,., i 1�'1�'+.{"L,� ,� - r'�'.:�».l �„r i•l,.�;,y< it � !!S,!,,': C.�:*.1�'� �:..;�•.��.�..,?,,iC.� ,:.'��'F..1o,�ts�,�."'"'�. I"°, i�2,,u.w ~�'�-+4`l�;t"�:��.-R�...:E�i.i`«.`. b,_ ,y't:.st�'.%=Y\t�w>t:,,; r_a:.-,:'^ „; t..?F' �f�iVa� �1�5 tlft,!=�,F'��'T7✓S"'e` t,\"t,�..a,...,.. _. ��eG,l'tia�'yx f�,t•.yi;.,l� S + t�f•, .:n ,....V!V - f'Z.�"�•.t � i. -. 3�-,f C 1 !""� .4..s3"h�.. -,.., t,t KJ '"'".:,., .-.i x,!°•—,.,.L i' ...u�.+: . -e.'l."»..,,; 4�.,... . 4 we+ _ ST DR. 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