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Home My WebLink About0275 WOODSIDE ROAD - Health a l 15 UJ oods, d R 00,4 rto...... .... THE COMMONWEALTH OF MASSACHUSETTS Asa/C� BOAR® OF HEALTH .................. .... .............OF.... ................................................ Appliration for DiipnsFal Works Tnnitrnrtinn Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Ie -----•......�??-_ _ ......lA?. �?. .ice-� ...:f.-•...d.. --•--•------•-•------•-----... 4.-I_ .................................................. Location-A dress or Lot No. .....=-,_.ate ��e r;f .................E.C9 d�WrJ......•..................... ........................ .[c�X.Scv ,......... ............... cane\r__ Address Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms..... ..............Expansion Attic ( ) Garbage Grinder ( ) '4 Other—Type of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures --------------- ----------------•-•-----•-------- -- W Design Flow..............6--5..................gallons per person per day. Total daily flow__._._..3.3.0.....................gallons. W �eptk Tank—Liquid*capacity_IC.00-gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------- ........... Diameter........to........ Depth below inlet......Le.......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) PercolationTest Results Performed by.......................................................................... Date........................................ Test Pit No. 1:...............minutes per inch Depth of Test Pit.................... Depth to ground water........................ f% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0: •--•----•--------------------•----•-------------•----------•---.............---.........----•---........---•-----.............--•----••-•----••-------------. Descriptionof Soil--------------------------------------------•----•------•---------------------------•-----------•-----------•-------------------------------•----------•--•------.------ x U ---.....--••---------------------------------------------------------------------------------------------------•----•-•----------------•----•----...-•--------------...---.........-•-----•------------- W x ---------------------•------•--••------•------•-----•------•----------------•-------------------•-----------------------•....._.....------•------•----•-•---...-----.....-------------------•----------. U Nature of Repairs or Alterations—Answer when applicable_______P'_00-------1.Q4?0 ....... .' '....0....... -----lay.---..- .ayu..E Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issue by the board of heal . Signed------ ..... ....................... ....3.... Da Application Approved BY------M.A.A.-S?--•-- --------- ---•- ------•---------------------------------- ...........?>--fit Date Application Disapproved for Me following reasons---------------••---..._..----------------;--------------------------------------•-----------------•---•--------- ••------------------------------------------------------------------------------------•---...-----------.._......_..-----------------------------------------------------•----------------------------... PermitNo...... .................... Issued_............................................. Date NoS5 imp .................. FEE 1.5............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH —7-0 w ...... ... ------------------ Disposal lgorkii Tonstrurtion "amit V Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: I ............. . ..... .....D.E!vt............ ............................... 7:................................................................... Location-Address or Lot No. 0's ...................... ...................... ...VVN...I.,:........................................................ ,Owner eddross -------*..---- ............. .......... .......................................................... .................................................................................................. Installer Address < Type of Building Size Lot............................Sq. feet 2 Dwelling—No. of Bedrooms---- .ED_!..............Expansion Attic Garbage Grinder Other—Type of Building ............................ No. of persons._...__..............._.___. Showers Cafeteria aOther fixtures ........................................................................................ ............................................................. Design Flow..............5.. ............._.....gallons per person per day. Total daily flow.........3.30......................gallons. gp_x;t5 teptic Tank—Liquid*capacity.00DA.gallons Length................ Width._............_. Diameter._._.___.__..... Depth................ Disposal Trench—No. .................... Width.................... Total Length_....._...._._...... Total leaching area....................sq. ft. Seepage Pit No........t----------- Diameter.........._..... Depth below inlet-----!e........... Total leaching area..................sq. f t. 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._____..........._..___. P4 ............................................................................................................................................................. 0 Description of Soil........................................................................................................................................................................ x ......................................................................................................................................................................................................... U 'rt o ..r...... ---------- U Nature of Repairs or Alterations—Answer when applicable-------P ._QQ-------4000--- I-N...Yo............"t.............. ........................... ...... :;��VNrrovv�d -eQ tov -z>TowE, ......................................................................... Agreement: f The undersigned agrees to install the afored'e-seribed 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 of Compliance has been issuedby the b L"-f heal' Signed__\:::�,�, .... ......... ---------- ...... ....................... ............................... Application Approved By.. .............. ff e . ...-3 _jai? ,.V ----- ----- .............................................. ... ... .......................... Date Application Disapproved for e following reasons:................................................................................................................ ......................................................................................................................................................................................................... -3 — 1 4? —V11CLN, ............................................ .e..... Permit No.----. ..................... Issued Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH- .................................................................................. ................................OF. (9rdifirate of TOMpliattirr THIS-ISTO CS�RTIFY, That the div dual Sewage.Disposal System constructed or Repaired o, -e by------------------- ..... ...................................___................................................................................................. Installer Iler at.................................................................. . has been installed in accordance with the provisions of TITIZ 5 of The State Sanitary Code asv a r the application for Disposal Works Construction Permit No---- ............... dated-. 1 7kc� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS RUED AS A GUARANTEE THAT THE' SYSTEM WILL FU CTION SATISFACTORY. DATE............Z...... .......................................... Inspector............. ............. ----------- ----------THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............. ............................... No......................... . .............................. ............ FEE.... ................. Toni 4:udion famit ., � et .V5 Permission is hereby granted___ ......;:5 I.e,................................................................................. to Construct or Repair an Individual Sewage Disposal System w� le& ................................. ................... .............................................................. Street o. as shown on the application for Disposal Works Construction Permit 95- N ..........114f—Dated.......... ....................... --------------------------------------------------------- ---------------tl& Board of Health W 6...................................... DATE............. FORM 1255 A. M. SULKIN, INC., BOSTON r� No.. JS�. ....... ...._..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 74A�.�.................OF...A.0.i .e S� /..,(..........:.: Applira#inn for Binpusai Works 'Tnnsirur#inn run if Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: a � �.,�-�� y�_ sr- _ ............►�.�.:�. .�... �................ .. s Location-Address or Lot No ............... ..4e& ........:f��,fl T..,Y......, ,i1�.�7...............�.'�......en-Z4.;....../ .4 •!�c .:.S..l.......... Owner Address � .............................................Installer..<...,.................................. . ..,......,..................................Address.......................................... U Type of Building Size Lot..... st�vll�� ....Sq. feet ►.� Dwelling—No. of Bedrooms....... ............................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures ................................................ W Design Flow....... ..:........................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacit4i� _._...gallons Length................ Width................ Diameter................ Depth.............. x Disposal Trench—No. .....- ._ Width.................... Total'Length.................... Total leaching area....................sq. ft. Seepage Pit No..�� .8."....j.- iameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_--.___-._-___.__-_.___. �14 Test Pit No. 2...............minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ••--•------••-•-•--•-•--•-----•--•-•--•------•-•••----.....-••----•---•-••---•--•-••...................•--...•--•-•--••....................---••------._----- 0 Description of Soil............................. 'TA,�v� �..._®..._...._.1 FST-/51gC 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate\of Compliance has been 2s &6y the board Whealth. Signed. ----u Date Application Approved BY-------- / . ................ ' -!--- ._. � / ate Application Disapproved or the f o to 1,1g reaso s:___._.__,_ ................................. -• ... •--• ...44.---- .... Date PermitNo......6..D.._I..................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .i OF R, , ................................. Appliratiou for Bigposal 19orks Tonstrudion prutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ....... •,.f'u+ cp 4 t4' ..e^ - -.- ......... 4 .., ............................ ... ...i'.L..... w...... Ei':,,..,-. ..: ' Location-Address or Lot No. ......, .�.. .... :.✓ .1::.........,� ,� pt t ......s tr jaw, .........,. z :;t.....e, " Fs...r.. �;c a ......... o. Owner Address W � ............................................. ................,..........>........,.... ...................................................................... .. ,..................... Installer Address Type of Building Size Lot...... : ..w; a,__Sq. feet Dwelling—No. of Bedrooms........ ....,,...........................Expansion Attic ( ) Garbage Grinder ( ) '04 4 Other—Type of Building ... No. of persons............................ Showers — Cafeteria Other fixtures .._- Design Flow ' rv .................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacit 'f-1..._.gallons Length....--_.------.. Width................ Dian eter......... ------ Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..__ t >.E ITiameter.................... Depth below inlet.................... 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------------------------ f-L, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ ------------------- ------------------------------------------------------------------------------------------------- -•----- ----------- p w :... Description of Soil .;_. � .s� >' � r f M , =-..- W U 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 been issued-by the board of health: r Signed Date Application Approved B j .., f>f; Date Application Disapproved for the f ollowinq 1easons-- --------------------------------------....----............----------....------------------..........--........ -------------------------------------------------- ......................................I................................................ ............................................................. Date PermitNo.......i�=e u...................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .:. :,, ......... x' �. .............................. Trrtifirtar of 11utpliattre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) b ............ R ......................... --•.............................. ................................... F ° Installer has been installed in 9accordance with the provisions of Artic_le X1 of The State.,Sanitary Code as described in the application for Disposal Works Construction Permit i�,o::;..._ __________________•-__ dated � ,_. .:� :_-._----_. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. r" DATE---- ::. -J - -r:. :.......... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No......................... ; .✓ ;=a t:: FEE. Permission is hereby granted....... `~ `� =•A .... to Construct r( ) or Repair ( ) an Individual SewagWbisposal System at No _.U. ;:...... ... ............. .r.. ........ �, ;�.� a l `. ............ ....... � �. f r ` ._ astreet as shown on the application for Disposal Works Construction Permit No._ _;�__;.e -._.... Dated.... .,...�.�� ................ --------------------- •----...------------------------------------------•--•---•--.........------......_ o. _� ` Board of Health DATE •; r,z• ------------------------------••-•-------•-• _ . FORM 1255 HOBBS & WARREN. INC., PU91-ISHERS