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HomeMy WebLinkAbout0094 THORNTON DRIVE UNIT UNIT 4 - Health 9ily'�Thornt6n-Drive -• ' ` - A XQ 014" 1'Y1 S �... No............ JS..... Fu�...... .6...G...... THE COMMONWEALTH OF MASSACHUSETTS BOA OF HEALTH 1..0IVjV. . ...........OF..... ./4: / :.U.Va'JIC................ ........ .... .' . lifiralban -for Magma parks C�nnwlrnrttnn rrm t Application is hereby'made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: q .L..... CA�drges2 ! G o.. pt No. T /� d✓ir. c fill�� 11•�! .- -------•--.......-•---•-- ---------�--����.n..�.....l,.Q�r!�...1__.�-•--��_S.G_--•-----••----"�. Owner Address ' a -•------.._ .0 5:. C1.SJ.rZ ...................................Lt ----• .....---- �... Installer Address Q Type of Building Size Lot.... �,,__�1_�_ __Sq. feet V Dwelling—No. of Bedrooms---------------------------------------------Expansion Attic ( ) Garbage Grinder (MVO Other—Type of Building -__________________________ No. of persons....c7................. Showers ( ) — Cafeteria ( ) dOther fixtures ------------------------------------------------------------------_------------------- W Design Flow..................:.........................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—"Liquid capacitv/w�---__gallons Length------(a....... Widt•h4_.......---- Diameter................ Depth.-.-_____------- xDisposal Trench—No. .................... Width.................... Total Length____:________--___ Total leaching area--------------------sq. ft. Seepage Pit No-----_-------------- Diameter----__.._______-__-_ Depth belo inlet_-________-----_.-. Total leaching arena------------------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) d /VC/A Percolation Test Results Performed by-----------------------------------------------........................... Date-..------------------------------------ a Test Pit No. I................minutes per inch Depth of "lest Pit.................... Depth to ground water---------.__.._.__._---. (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water---:-------------------- ----------------------- -------------------------------------------------------- .......... --------------•-- x Description of Soil U 1.. ----------• --5 :-' - ". --Q c�, c.> +� = •- .cea .k.+� C"mod-.4C- �= UW ------- 4d'- -�s ..�! ---------------------- -------------------------- 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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has jbDe 'ssued by the b . alth. Date Application Approved By--- ,e-, - . ---- 3/....� -Z------ Date Application Disapproved for the f ollowing�reasons:..._...... ..................•-•-------••---------------------•---•-----------•••-----•-•-----•------•---- Date PermitNo........................................................... Issued........................................................ ., Date No......................... Fx$.....5..........U...... THE COMMONWEALTH OF MASSACHUSETTS 77-0 EOAROF HEALTH Lv� ...... .. ..OF........ .A.rr ...�' A��l :............................... Appliration -for 1:1ripwial Eorko Tomitrurtion Prrutit Application is hereby'made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 1 Location-Address or Lot No. .4.rZ � `'-i .........CY!� t-�� T �-�....................../7r.. f._��u r c..T / _� r�� i Owner a Address — n v u R C ,<C,4-7 -- l v c I +�--- -----------------------------------------•--•- -- ------ -------- -•--•--•--- .....--------------------•- � S Installer Address d Type of Building Size Lot..... U..Q.GLU..Sq. feet U Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder (V t) aOther—Type of Building ---------------------------- No. of persons....J ------------------ Showers ( ) — Cafeteria ( ) a' Other fixtures -------------------------------- - W Design Flow--------------------------------------------gallons per pet-son per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity!°`'"__..gallons Length------(_-------- Width..?------------- Diameter.-...........r.. Depth._.._......._-. x Disposal Trench—No-------------------_ Width-------------------- Total Length.................... Total leaching area-------------.------sq. ft. Seepage Pit No..-._--------------- Diameter.................... Depth belo� inlet_--_-.-_-___.._...-- Total leaching area------------------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) if7� /9G I. . aPercolation Test Results Performed bY..................................................--------................ Date---------------------------------------- Test Pit No. 1----------------minutes per inch Depth of "Pest Pit.................... Depth to ground water......._............... 114 Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water-------------------- -- .... --------•--------------------•----------•-----------•--._._...-• --•--------------------•.... .......................... 0 Description of Soil------- C P .. I --•--•-••--•----- •'j� `�s�_y G �' '�/.rs �E - .r A, _" �-------------- U --..._....-•-•-----•--•-L�•...------1-2........p�d���� �y� 'dea!C<�ir�-u_--:--�- �' i/`e�i ±.!_.� s�-a�.f �------ 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 bee ssued by the boaxd of-k alth. 1gn d- x✓_ «-r•fir, 'm I Date Application Approved B . ce".a�...- yr•- . .. e" v' . �._ _._....-.. PP PP Y-- - r` - Llol,+-��G--------------------------------- -----�-"----,-'- - -- ' Date Application Disapproved for the following reasons:---•---•------.. --- --------------_-------------•--------------... ....................................... .......................•---•----•-----------------•.----------------.--------••-•-----•---•--••-•---••-•-•----------- ----•-------•----------------•-----------•---------------------------------------- Date PermitNo......................................................... Issued...................... ................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOA OF HEALTH .w...tv............OF..., ...../1.. ..oU...S....L... l. .................... 10.1rrtifiratr of Tomphattrr THIS IS TO..G�RTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by `� �= y`=--.T---------------�--� -......--------- -------- _ _ IC ... at-----to...-...... ----------T h'u-rZ n............................�+� j s�ll�--------- --'=••� -��--'�--� �•'••• -•-•--....-•------•............. has been installed in accordance with the provisions of A icT XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No r7./.... ;-...................... dated_.-./ t1�.-..-.?__.7............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-- = � ------ f% Inspector......._r ;� = --------------------------•-•----•-.----- THE COMMONWEALTH OF MASSACHUSETTS BOAR F HEALTH s ' .......�v..LIJ..�._.......OF.......�.... lL!7J..: .`?.. ....... No......................... FEE.----), �.(:1..... DitiVagal rk � tt tr rti�a rrmtt �y Permission is hereby granted...v `. ..1 .;././................................. fl T ................................................ to Constru ( or F it ( ) a- Indiv' ual Sewage Dis oral System (_ Street as shown on the application for Disposal Worts Construction P.uri No.....,. -, - Dated----- � __..___7 --------- Gl�tr . 1��1 ..- -- ---------------------------- _. DATE................................................................................. Board of Health FORM 1255 H0813S & WARREN. INC.. PUBLISHERS .; --.. » ;:. 'vA- ^-'.2S'.*�r , -.. .. 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