Loading...
HomeMy WebLinkAbout0026 ALLYN LANE - Health r rti 5 0.` r 3 �o p � LOCATION SEWAGE PERMIT NO. Lo7- S A LL/ 1\1 L IV) VILLAGE I N S T A LLER'S NAME i ADDRESS A127Wo2 JAIS OR OWNER , DM y N D r T< DATE PERMIT ISSUED ���901� DAT E COMPLIANCE ISSUED � �� Ln T'k o W .Si 4 f cA Y PPPPP �J 3 No ........... Fss ........................... ._ THE COMMONWEALTH OF MASSACHUSE77S BOAR® OF HEALTH 11� Q .tA......................OF.15.AV ST -lLf.--•---.....-----..--.................-- , ppliration for Dispas ai Works Tonotrurtion ramit Application is hereby made for a Permit to Construct (k) or Repair ( ) an Individual Sewage Disposal System at: ..E.O W Nil.._....Q.a..P.1. �r.............................• ......I.-O J� .....-..........-.......... •-- oca ion-Address S rdo-sift • or Lot No. Owner Address a - •- -------- --•-• � .h1S� r 4.. ....1 5. ---•-•- taller ........ � Ins Address UType of Building Size Lota®,�. a.%.._..Sq. feet �. Dwelling—No. of Bedrooms..............k...........................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Other fixtures ..-.... ......................• W Design Flow....................J5�'............gallons per person per day. Total daily flow................ .+.f�..._..........gallons. WSeptic Tank—Liquid*ca.pacity..ic1,9. .Jgallons Length.....1.0..... Width...5......... Diameter................ Depth-.._5........ x Disposal Trench—No..................... Width.................... Total Length.....................Total leaching area....................sq. ft. Seepage Pit No......A,........ Diameter....._ ........ Depth below inlet........(GB........ Total leaching area.-4o..V.....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.... Q.k-£..................... Date....fj.u.tv Test Pit No. 1....° ,...minutes per inch Depth of Test Pit-----A;L1...... Depth to ground water.....IV A--..---- 4i Test Pit No. 2................minutes per inch Depth of Test Pit-----{.X........ Depth to ground water-----ti.,,L 1.. ...... 94 •-------------------------------- ---------------------------•••-------- O Description of Soil------.<-LF -1� .Y�.... --•�.l ��----------- �T � �.� ------------------• V ...................•-••••...-----..........---------•••-------•••--••---•--••-.....-------•••--•----------•--•-----------•--••••--•------------....-•---------------••---._.......--•-•----..........--- UW ------------•------------------------------••-•---•-•-••----------------------- 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.TIT 1 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b ued by th Thalt ate Application Approved By.. ! �� f � Date Application Disapproved for the following reasons:........................................................................................ ...................... ........................................................................•--------•--------------------------•-----------•--------------------•--...----------•------••-------------------------•-••----- Date PermitNo......................................................... Issued....................................................... Date No. Fps.., d.'............ s THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ` OF C A.3....:�iSTA-P,L --- '-'.1:".dw.t....................... Appliration fqr Bi-gloaa1 Works Tonitrnrtion ramit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: . ....... ..._... ... .... ........ ..................... ...... .........._....................................................................... Location Address S( ,i or Lot No. 101 V; nmxur'�( A JV; NtU< `1_ C©SIAlF f 65i�'�'�• /��LNI nJ • ------•-•--- ------------------•--•--•----------•-••••••------------•••-•••------•----•----------•-•------•--- Owner f Address a U R TA l�L 1: MASS Installer Address Type of Building Size Lot �.`'�_�___�__�_.._._Sq. feet ' U Dwelling—No. of Bedrooms........... `_______________ _Expansion Attic ( ) Garbage Grinder ( ) Other a —Type of Building ---------------------------• No. of persons____________________________ Showers Cafeteria Otherfixtures ------------------------•-----••---•------------------.-••••••-•••-•••••--•••••-••••••---•-•••-•-•----•---•-•--•-•-- ._... ..(.......).w Design Flow................... ................ per person per day. Total daily flow...._.._-___.._.4A.j�l..............gallons. WSeptic Tank—Liquid capacity_ `_ja'gallons Length----1.(a..... Width._. ;_------- Diameter________________ Depth... --------- Disposal iTrench—No_____________________ Width.................... Total Length.................... Total leaching area................_...sq. ft. SeepagePit No....... -------- Diameter._._._r......... Depth below inlet.......<?........ Total leaching area_�_`......sq. ft. Z Other Distribution box ( .) Dosing tank ( ) aPercolation Test Results Performed by...IZ.._ � :tj? N1L Q, Date._._................................... Test Pit No. 1...._.`'--___ ______minutes per inch Depth of Test Pit.....!_a�_'.______ Depth to ground water_..__A)��--------- (i Test Pit No. 2................minutes per inch Depth of Test Pit.....l.�__-______ Depth to ground Water----_11_1.1A........ P4 -•••-----------------------------------------------•-----• ....................---.......................................................................... O Description of Soil....... �_rAV\J_.�! _r1...J<-_,< i lU ( ►� 0 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 T ITI,% y g g P y 5 of the State Sanitary Code— The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has b ssued by t"oardQf health. Sined t�tt� � . . • ---•••••----•-••-••- ...-.... ate Application Approved By. f ti`. �-! Application Disapproved for the following reasons------------------•----------------------------------------------------------------•••-••- .................... -•-------••-----•----•-------------•-•=----------------------...---•-•---------------.....-----------•---••--•••••-•-•---•-••----•-•------•-•-•••••-•-••••-•-••-•••------••............................ Date PermitNo.......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH k !..../....l .t;1.,a...........OF.._. ....................................... Trrtifiratr of Tomplianrr H, THIS IS TO CERTI That the Individual/ ewage Dis sal System constructed or Repaired ( ) b3'�-•----- ---••• -4= -*-__._..._� _ ....................................................................................... . Insta at .. ' ..��er, --------------•----•----------•---•---- has been installed in accordafce with the provisions of TIT LE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No . __- __. dated-............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL—NOT BE ONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..............................�A -�j(� ......................... Inspector-----. .=-....-�s----..--------------------..._._.........._..._..-----•------••-- u, THE COMMONWEALTH OF MASSACHUSETTS 8n 3?6 BOARD OF HEALTH *� • OF..... 1�. ...... FEE,0...._2d_....... Disposal rkv T-Win' otrytion Vprmit Permission is hereby granted............... " c--_ ..'.^..^'--- -•---.._------------- ................................................................. to Construct or Repair ( ) an Individual Sewage Disposal System atNo......... _____--. .----•-••-..tom ' - -------/-----------•--_-_--•----------------- • --•------ treet ) KJ 9 as shown on the application for Disposal Works Construction Permit No._____/_____._ ___ Dated............. l oard of Health DATE..............'05�......—.. -__�o�..� FORM 1255 HOBBS & WARREN, INC., PUBLISHERS _. .. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _._ -_ _ _ - _ _ _ _ _ _ _ _ _ _ _ L IL I L E 2R Dn R Rffipf&Associates,Ina New Entry �' pm �Anftctm L42RDn 2 Sides Double Door 73 4'-0'1x ro'-8' \ Existing Up �gl8j r+�sers r� 2 O «..m.ee _ Dining Room x 6� 0 l 2'-0' x Post Location rra 12-031 Living Room Iwo 09/14/12 - >� 2'-6 x 6' 8' I ' ReF Ex tine Dn �, �.» ...�... I Review Cabinets/ S 1 Exists U S Counters St le 8 O Cooktop/Oven w/ f I I I p O Materials 4 ConFig I Microwave Hood L-—-——-J L--- w/ the Owner Kitchen ; _ I Sink w/ Disposal ; Q r D J Dishwasher Pitcher Residence e rYr Czar a L— W I Addition Project _ - . , lye New Faml Room +I �I. �— y �! Brm�et,abb,Mmeaer.,eeccs a. »: v e 12' 0' x ro'-8' - Firm RO Hgt , Con d1V 1 /fir EDP 4R Dn ; I M, 2'-0' 6'- L 4 2R Dn = � Q. I_ 716�� -�..J° 3I-10;' �. -15�_gp 12'-5��+ 13,_3n First Floor Plan 41 mum as noted nr.fs xsrw - - - - - - - - - - - - - -- - - - - - - - - - - - - - - , A 1 . 1 . I - 1 First Floor Flarl Va = 1'-0 rra 12-031 (05/12) r - - - - - - - - - - - - - - - - - - - - - - - - - - - - - = - - - - - - - - - - L , � IL I New 3ro' High Railing Confirm R Rump(&Amdate�Inc Configuration w/ the .Owner rra &%D.Mu meth am — — , OM 740 /per _— Double Dr` Slttln Existing ; H. >;- x 6-8 Room Bedroom 01 rra 12-031 — x 5 rn - w O9/14/12 m 2 O Existing Dn I I I Master � rn - 1 j Bedroom 2 X 1 I Play Robin I x f _- w _ L S , 2'-0' x ro'-s' Bah Bedroom 02 r-J-t E�usting Dn C4 Pitchy Residence 1 Addtaon Project 24' x 6 s' x 21, 13rmro�'cdob Maeeaehueette Master .Bath Double Dr 3'-0' x 6'-8' _ - SS. °® 15'_gn 12'-aUt Second Moor Plan 41'-8u± ado as noted na..ets N=bm I _ _ _ _ - - - _ - - - - - - _ - - - - - - - _ _ _ - _ - A1m2 _ _ _ _ _ _ _ 1 Second Floor Plan/ Va rca 12-031 (05/12)