Lot 1 Septic Applications CHECK OR FILL IN WHERE APPLICABLE
Fas...1...:
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
C2tty OF e� 6'bectr []I
1�ppliratiiun fur lBinpusai rr;urks t nwtrurtinn 1trwit
Application is hereby made for a Permit to Construct (I ) or Repair ( ) an Individual Sewage Disposal
System at:
(\441'
Y''``
tt-L ;ri� ' l
r . Iaratlon-Adores or Ist Na
h!<azl._ - Ccsk�alyn.
Address
.1(]dross
Type of Building Size Lot Sq. feet
Dwelling—No. of Bedrooms Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building No. of persons Showers ( ) — Cafeteria ( )
Other fixtures
Design Flow 'q F pp gallons per person per day. Total daily flow gallons.
Septic Tank—Liquid capacit} .O.gallons Length Width Diameter Depth
Disposal Trench—No. Width Total Length Total leaching area 6O0 sq. ft.
Seepage Pit No Diameter Depth below inlet Total leaching area <q, ft.
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
Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water
Description of Soil
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 urther agrees not to place the system in
operation until a Certificate of Compliance has been issued by the boa lth.
Si ned.._.( tcaaaCn.,.edi..
Application Approved By .e 2`..{.!r;fa ._ ..iy�flx 271
Application Disapproved for the following reasons'
Date
Permit No 215)--
Issued..
s
Date
A7 1..9.7r/
rri
No 786
THE COMMONWEALTH OF MASSACHUSETTS
PEE/ 5T6(
BOARD OF H EACLTH
dike- ���
OF yi V /)
Application for Buipuyal darks Tountrurtinn Iirrnut
Application is hereby-made for a Permit to Construct ( ) or Repair ( ) an lndis idual Sewage Disposal
System at:
a or Lot Yo
Address
Add es
Type Size Sq.of Pnitr ng Si q-
feet
Dwelling—No. of Bedrooms Expansion Attic ( ) Garbage Grinder ( )
Other—Tape of Building No. of person. Showers ( ) — Cafeteria ( )
Other 1xures
Design Flow gall(xrs per }o son per clay Total d ily flow gallon-
Sept ic teak—Liquid cal Ku-it/3 OOdalrnrs Length AAidat Diameter Del
Dsposrd Trench—No.---___-- Width Total Length Total letchiug area sq. ft.
Seepage Pit No Diamete- Depth below inlet Total le tag .acs_.. Re c.
Other Distribution box ( ) Dosing tank ( ) /166 r£ ��"sta� d.c4Of
Percolation Test Results Performed by CI Date
Test Pit No. I minutes per inch Depth of let Pit Depth to ground way-
Test Pit No. 2 minutes per inch Depth of "Test Pit Depth to gr■ tmd mater
Description of Soil
Nature of R ep:rits or .Al
hen applicable -
Agreement:
The undersigned agrees to install the aforedescribed individual Sewage Disposal System in “cc0Han ce wit].
the provisions of Article NI of the State Sandnay Code—The undersigned further agrees not to place the system iu
operation until a Certificate of Compliance has been issued by the board of health.
Application Approved By tJ- > - etien DLL;-.19 7
Application Disapproved for the following reasons
'HERE APPLICABLE
CHECK OR F
No
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
City OF Northamtton
FEE
Appliratinn fur 3Jiupugal iinrku Lnn. trurtiun ]rrmit
Application is hereby made for a Permit to Construct (gxJ or Repair ( ) an Individual Sewage Disposal
System at:
Lot 1, George 'Tobin Land
LocatioatAddrese
no.
__G.ao.Pge �'obiti 21 Kimball St. :r `lorence
or,n,r
Installer
Address
Type of Building ddress Size Lot 12,000} Sq. feet
Dwelling—No. of Bedrooms 3 Expansion Attic ( ) Garbage Grinder
Other—Type of Building No. of persons Showers ( ) — Cafeteria ( )
Other fixtures
Design Flow 50 gallons per person per day. Total daily flow 300 gallons.
Septic Tank—Liquid capacity 100°gallons I ength Width Diameter Depth
--
Disposal Trench No. Width Total Length Total leaching areaU0U sq. ft. Min.
Seepage Pit No Diameter Depth below inlet Total leaching area sq. ft
Other Distribution box ( ) Dosingtan�° c ffj� ) _
Percolation Test Results Performed by.._L.(._.Niot_L..�_ .. ti. ., Date 7-8-66
Test Pit No. 1 11 minutes per inch Depth of Test Pit , epth to ground water none
Test Pit No. 2 minutesper inch Depth of Test Pit Depth to ground water
Rotton ledge at 41 . Sitilid ledge at 71
DescriptionofSoil Glacial till, silts.
A bed should be constructed at this site.
Nature of Repairs or Alterations—Answer when applicable
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to
operation until a Certificate of Compliance has been issued by the board of health.
Signe
Application Approved By-
Application Disapproved for the following reasons
George robin
Cock-c 1 07 .
in accordance with
place the system in
7-8-66
Date
Date
Date
Permit No Issued
Date