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HomeMy WebLinkAbout0186 PALOMINO DRIVE - Health i 0q F a a 4 1 7 i i tI f No. 4210 1/3 BGR � iI ESSELTE 10% s r a e ASSESSOR'S MAP N04? 7 6H"PACEL : _ 10H S E W A C E PE RWIT Me. V-iLLA: E �I.,- 0 �C 1NiSTALLER'S DAME A ADDRESS D U I L D E R OR OWN ER DATE RERMIT 155S ED DAT E COMPLIANCE ISSUED ��� ZC a ' s�� 0 4SSESSORS MAP NO: 177, 3 © PARCEL NO.: 2 9 a No Fes$...pa:............. THE COMMONWEALTH OF MASSACHUSETTS � BOAR® OF HEALTH - ....►.t wn..............OF.....i�4.T.'X vUL........................................................ C "� IQ f 4 Appliratioaa for Bi-nVugaal Works Cnowitrurtion thrmit Application is hereby made for a Permit to Construct ( ) or Repair (#J.) an Individual Sewage Disposal System at: ----------- ---------------------------------------------•----.....----------•---------------................. Location-Address or Lot N -----------------•--- -------• ._ .. Owner Address a ..........A t B 'Ca c►s N J .36c lyltsin ------------------- ..... Insta Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) pa., Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures -------------------------------- . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth-----------_--- Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No_____________________ Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results. Performed by.......................................................................... Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water--__-----__-_-_______._. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 ------------------------------------ •----...----.........:... ....--------------- •------------------- --- •---------- •••--•------------------------------------- 0 Description of Soil-•-----------------------------------••--------------------------•-----------•------------------•---...--------------------........................-.................... x x --•--•-------------------- ---•--------••-•-•----••--•-------•----•------•-•-----•---•...••---•--•----=••-••--•••-••-•-•-----•--------•----•••-. ••••-- ----•--•-- ------------- V Nature of Repairs or Alterations—Answer when applicable__ c* __--4r ... ¢�&__PA_b_ nQ....... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TILTHE 55 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 hea th. Si Z g!o A lication Approved B ..............: a. ..._....... -.-..-.-- � � PP PP Y . •• y Date Application Disapproved for the following reasons:------•---------------------------•---------•----------•----------------------------......................... -----•-•-•-•••--•-•--•-•-•--•-•-••••••••.................••--•-•-•-•-•-•--••--•-••....-------••••-•••••-.••-----•----•----•-••--•-•-•-----------•-•-------•...-•---•--•--••--•••......-•--••--•-----•--- Date 15S Permit No................. ...... ..... Issued-------•------------------------------•------•-------- Date No.`—e-f-'.... :_............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH L------ -A...------....OF....'' Appliration for Diipnoal Works Tonstrurtion lbrutit Application is hereby made for a Permit to Construct ( ) or Repair (ik ) an Individual Sewage Disposal System at: r� _ I is(, PfAc>r,lInlJ j)r%0Q, �'.,f,r11�� t� •-------------------------------------------------------------•--------•-------•------•••-•----••• •----.....--------•-••------------•-----------•-•-•-............-•._........_............•••...--- { p Location-Address y or Lot No. �Ct3C.M1E', +Y�rt11 Ei to W!% 17tt�2rs !r� 3c?-- -��%=cr_+ .......................... ....... ............................................... ') Owner __ t 4 Address A I- �j On,cd _ S-0 fil trin .�.AaA'�- . lr.uP- r 1,'itYt4�i,r,#fv.............. ..---------".............•--•-----.....--••-•--•.-------"•--•-"----------•-"----•-------------. ........... ... -- Ins'alier Address Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) Other—Type e of Building _____________•_•____-____- No. of ersons................._..._______ Showers — yp g p ( ) Cafeteria ( ) 0.1 Other fixtures ....--•-•--••---••-••-----•--•-- . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth__-.___-___-__-. x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No-_----------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ W Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' -------- •------------------------------------------ ------------------------------------------- •------ ----------------------------- --------------•------------- ODescription of Soil....................................................................................................................................-................................... W V W ------------"--------------------------------------"----------------"---------........_....---------------------"-------"-------------••---••-•-•-•--•----------•• • •---- U Nature of Repairs or Alterations—Answer when applicable......._ �{�--Q_-:�'ls.��..._� .__r-.t� Q'�-----------------'rwr.ttlr.� I --------------•-•....--•--•-•--•---------•--••--•-••--•••--•-•----•.....-•-•--•--••••---------•-•-••-------•-••-----•-••......-•----••-•--•.......................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TTTt...E 5 oi 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. } Si tied �_:...._� _, _ �,CM 9• Z (n ------------------•.................................. --- _.... —___ r�y ' Date Application Approved By------------- -------- -�? "a?�- -=---!'�- al ............................ ----•-- ------ ----- --- --- Date Application Disapproved for the following reasons:................................................................................................................ ........--••--••-•-••-••••....-•-••----•••--••-•--•----•------------•-•---------•-------------•.......---I------------••-------•--•--•-•----••-----•----•-•-•-----••------•------•...----------••......-- ------�--� Date PermitNo.............. .......... 7•..... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS U BOARD OF HEALTH j 4 .............................................................. Tr " irtt#r of Tompliana THIS IS� C RTI Y That.,the I divi al Sewage isposal System constructed ( ) or Repaired (.4 } by................. -•_- Il.. ::::.:...... ?1Jf1/ N --- . Instal has been installed in accordance with the provisions of TI T ter:. j of The State Sanitary Co s des,gibed in the application for Disposal Forks Construction Permit No. ___ _ ?___.__. da.ted_...____�f._.Z_� __r ________________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL F N T N SATISFACTORY. _`� DATE.............� ......................................... Inspector----------- lr�---------------------------•----------•--------------------- pCl��' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Q n..................OF..�6 cli 11 �� ...... ""-' •................•--•--.........._............_........... N FEE..96 Disposal Vorkv Tonotrurtio p mit Permission .is hereby granted....... C !vr.v�.1........ Con truct, ) or Repair ( ) an Individual Sewage.-Di System AA -•----1___..""-- -----�-c�-----•-- --------------- ------_-----••-------------`-- ------------ Street as shown on the application for Disposal Works'Construction Permit N ___________________ Drat _ = "_,----?Ara............ .......................................... Y ._..._ __________................ Board of Health DATE— .. t � t FORM 1255% HOBBS & WARREN, INC.. PUBLISHERS LOCATION SEWAGE P RMIT NO. VILLAGE I N S T A LLER'S NARIE b ADDRESS R UILDE R OR OWNER gz--T�5-A2 DATE PERMIT ISSUED DATE COMPLIANCE ISSUED - —�� 1 ��. �r _��_ �� r r"� _ � � � <- .`Z No �► - rFss.:: �� THE COMMONWEALTH OF MASSACHUSETTS TM BOAR® QF HEALTH .( ...........OF......... .. . .. V5—� t._....- .11..... Appliraation for Uhipoii al Works Towitrurtion rami# Application is hereby made for a Permit to Construct (V or Repair ( ) an Individual Sewage Disposal System ..........:..:r� .E-11. �. ! ,��A. /llt� ............................................................------------------• -- ,Location-Address , or Lot No � � 1 �1 � - � ............. ...... wn A O ��..e� • Ayddress a .......................� Kd• ..... W / .............. T aft._•-- �//. �-.__ _ 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 ..---•-------•.................. • -- d ..............•-------•.....................----------- W Design Flow.........573...........................gallons per person per day. Total daily flow. j 3.P............._......gallons. WSeptic Tank—Liquid'capacity.....__..__.gallons Length................ Width................ Diameter_______..__---_- Depth................ x Disposal Trench—No. .................... Width.................... Total Length......'............. Total leaching area...................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area...................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) `" Percolation Test Results Performed by.......54X�'C�?-.J..�.L._e......................... Date___-•r�--�_1Ae ............__.. 1_4 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.._.s:................... (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water----- ................. ---------------------------- 0 Description of Soil........ . __._4�.... v W -----------------------------------------------------------------------------------------•--------------------------------------------------------------------•---..----------------------•-------------- U 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 iITi LE p of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b n i sued by the and of h lth. d. G ... . ------------------ Application Approved By..... -• . . ..e4 . 1 .....-••••........................ ••...1v,�� = ���� Date Application Disapproved for the following reasons---------------••--------------------------------...-----------------........................................... .................................. ...-------•------=------..-...••---•---•.................... ----•...•-------•-•--•--------------•-••----------•---•• -•---•--•--•------ •---------....... / t Permit No.- 1Vi ---- e -- ." D� Issued_ --••--•... r ��IfDate ` No.----•--?�L-------- F�s...� ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for Dispos al lark, Taftstrudion ramit tAppli&tion is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System ----- .... : ! .ri, D.. �. t ....................................... -- '- - Location Address' or Lot No .. .. . � •�?, .. �'� .._.. .... �' .._/" mil.�t " .... a�.- ,F" 1!�,1 : a�t... Z . Ow Address Address Installer. s Type of Building Size Lot................ feet U Dwelling—No. of Bedrooms.......... ............................Expansion Attic (' ) Garbage Grinder (IVm) Other—T e of Buildill No. of persons----.__•-___•__-_-__•__--__- Showers — Cafeteria Q' Other fixtures ..............•---------••••---- . W Design Flow........:; :Z............................gallons per person per day. Total daily flow........... _: .....................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth........... x Disposal Trench—No..................... Width.................... Total Length................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '"' Percolation Test Results Performed by..... x. :?:T"f.= _ a_. 1.l.4 _________________________ Date.... . . l_.........._...._: aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water............................ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... ------•--•---------- •••-• .....----•-••---•---•-•---•--•.... •--•-•----•...-----•......................................................... D Description of Soil....... - /-,g� _4�:�.. I Z __.1 �.tg` _... ._.. t 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 of Compliance has b n I sued by the bard of health. 1 �... Application Approved By---• l �*- --------•----------•-•-•--- -...,�..._- 'Dace` �_ Application Disapproved for the following reasons-------------•--•----••-----------------•-------------------------------------------------------------....._...._ ---------------------------------••---•--.....-----•---------•---=------------------------------------•-------••--••----•-••-••-•-•-------•------•••----------•-•------•----•-•-...---------•---•-••••-- Date Permit No......................... ---.. Issued................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ,,r.... OF..... ... ' , °' s ................ 'Wrdifiratr of clmjl iFaurr - IS T ERT�..Y, That the Individual Sewage Disposal System constructed (�r Repairedby --_---- - _. ...../ Im idler—at-••II ► ' ......................... at been installed,in accordance with the provisions of T 5 of The State S nitary Code as described in the application for Disposal Works Construction Permit No ___.___ ..._� _ ___;?......... dated_._ ,-_---•-------------- l�, �-C'-- ill- x" -------------------- 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 .............OF.:... ..... ... ..... ... FEE._. .............. _a..'�.... .Z �af�ttrirt rrutif Permission s-bereby granted - ----±--------------------•--•----------------------------•-. - ........................... �') ;pair a d al S .r g Disposal Sys to Const ct or I •iv at No. r�- -y fC.1 d �Q = ' / Street as shown on the application for Disposal,Works Construction P it N D�alt�eJd-__- �'" . ''. f'�t........... --------------- Board of Health ..r DATE-------==�-------. . ............:.............................. FORM 1255 HOBBS & WARREN, INC., PUBLISHERS �Q�_ _t� ,�1 i jam..{'A.. - ,• � �.a � T,,at�� >`t..v,,v = t l a +c 3 = 3'�t� G,pt7. "Zt71 •G7�!:. i USA- t C:�C�U 6•b.L. (yX•I,ciAc1_ ACrA , tc,--O S.F. A. ` {cam ar � SO fs5=- C-�,R t7. TJA oTdt_ Z'7ESIGI.f 425 G•pn• s TaT&L •cA-t L-'-( bw p:r W--f—dc0LQTtt_)1._1 OINTE : CIQ IWO* QIz L". Ale& Y S2 , -TIT ACAI �•�Ot..�-. {����� •`- y '.� _ � ;, - � ' � ' ' a TPT,1=yo R�ia�.cs a LL • .. '�j''�iP�_. .. � °, Imo• . 'G,o•�. �ta.7�` .` ,tu � .. 2�3a0tt,. 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