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15 Applications & Permits No. �5'SS THE/COMMON/ ACTH O MASSACHUSETTS { g �. MASSACHUSETTS cApplictttion for !isposttl ' gotem Construction Permit Application is hereby made for a Permit to Construct( )or Repair an On-site Sewage Disposal System at: I rcnbn Address or Lei No AS h1/a &tea/� Ovens Name Address and Tel N be-e7/ / (t., iiStrke-t Installers Name.Address,mid and Tn No. Designers Narm Address and lei No Type of Building: Dwelling No.of Bedrooms Other Type of Building Other Fixtures Design Flow Plan Date Title Description of Soil Garbage Grinder( NE per Persons Showers( ) Cafeteria gallons per day. Calculated daily flow Number of sheets Revision Doe gallons Nature of Repairs or Alterations(Answer when applicable / fI f /34 r HG x 5�- Date last inspected' Agreement: The undersigned agrees to ensure the construction and maintenance of the aforedescribed on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and riot o place the system in operation until a Certificate of Compliance ha been issued by this Board of Health. Mign d y Application Approved by f . e er O►� Application Disapproved for the folio wi 4011Plerason s Date 6-7/74s' Dile_cS/i7/j S' Permit No. /S-SS Date Issued S-Iii/55^ THE COMMONWEALTH OFMASSACHUSETTS ,/ / )COMMONWEALTH •�_ stir"n MASSACHUSETTS Certificate of Compliance TIT/S Tf CERTIFT t the or�) F Sege Disposal System install/4c Tf o repaired/replaced(^)on at C") 035; l L., / a/ f r / 1 (Hsibeenconstructed in d fly 1t h/rot p p p of Title hi and the for Disposal System Construction Permit No / dated a z < . r/c 1 rr13 gfth €) t 4 cofdtto d f . C � pfov co pl Ih t c set forth tlhbclo The issuance of this certificate shall not be construed as a guarantee that the system will function as designed.This Certificate expires on), CL/7 / r l I '/_ CJ -1-{:../ n I /�'t ' DATE j .<-- • THECOMMONWEA}ATTH OF MASSACHUSETTS ✓ f ' c � / >5 b.-/l; /by 1L"" MASSACHUSETTS FEE !ispasnt e gstent Construction Permit yr lull 1 . Permission is hereby g(a/lted to t / toe 7trlJc(( )or repair(1 I an On-se Sewage System located at /'J - and as described in the above Application for Disposal System Construction Permit_The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special condition'. All construction must be pl ted within Iwo years of the date below. ' ,^ DATE / I, / _p ( ' AL./' ---- Appro ed by me.ins rte.Imam summit?.- asox ua THE COM ONWEALT OF MASSACHUSETTS iL' Tp_CERnr �` by ince with the that the M ASSAC H US Errs gertifirttte of comp!innce itc Sewage Disposal Sy�st�m--"installed ( )or repaired/replaced (X)on cwsor Le y ; �Ir rovisions of Title Ins been constructed in 5 nd the for Disposal System Construction Permit No /5 9 S dated se of this system is con441ioped on compliance' it the provisions set Furth below: e �IAP ..c 1' / r f (.Jt-d-YOU4d [12 %14I Ca ie issuance ate expires on thi ertifcate shall not''e c strued :et / ea as a gr grantee that the system will tunetio /7 /99S Inspector as designed. TI Jv( THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH C/Ty of /doer*944 -t/ Applirutinu far 1ispnsttl Harks QInnstrurttnn Permit Application is hereby made for a Permit to Construct ( ) or Repair ()c) an Individual Sewage Disposal System at: p.t // WE9T,f/.4 y cTa.r/ 'ed M1/ 1G Location-Address 15 E / 3 rrg.eq ,°,n�Ge Installer Type of Building Dwelling—No. of Bedrooms Other—Type of Building Other fixtures Design Flow or Lot No. Lac Y> We3TtYenP> es l2D /i/T.f% Address Size Lot �S .LS ....Sq. feet 3 Expansion Attic ( ) Garbage Grinder ( ') No. of persons Showers ( ))r— Cafeteria ( ) .�..5 gallons per person2er day. Total m flow gallons. Septic Tank—Liquid capac /./400.gallons Lengthf n.C. Width._.i Diameter Depth. Disposal Trench—No............ Width Total Length Total leaching area sq. ft. Seepage Pit No t Diameter/l_X/sue- Depth below inlet....,Z.S 1 Total leaching area..6$0 sq. ft. Other Distribution box (X) Percolation Test Results Test Pit No. I .� Test Pit No. 2 Description of Soil Dosin tank�(v Performed by .ry • rte..,2inl C/,9,PE Date..x5 2•61.-92- minutes per inch Depth of Test Pit a�4' Depth to ground water..., minutes per inch Depth of Test Pit Depth to ground water "re 5414 204 o.4,/ bki 9z-a28 Nature of Repairs or Alterations—A%wer when ap Iicable..,e ehetce .LE�4" e9t ?— avq,. cH,FC,r 4,GTve rreldeic Itteigr Agreemcu0 The undersigned agrees to install the aforedescribed Individual Sewage Disposal Syste the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not 'place operation until a Certificate of Compliance has been iss.-d by the board e health. Si d.... - i Application Approved By e Application Disapproved for the following reasons Permit No Date Issued THE COMMONWEALTH OF MASSACHUSETTS BOARD AO/F (EM—TH /- OF AL Olrrtifiratt of &motto P d Hire ) THIS 1S TO CE/i FY e' . th.'Indivi 1 Sewage Disposal System constructed ( ) or Repaired W ,y IIS. Lt c_ .. ms been installed accordance in accordance wit'n th:�.rovisions of TIT1-% $-f The State Sanitary Code s des rihed in the application SS Disposal Works THIS Construction Permit SHALL No fa._5 )— dated_ .G. If ya THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED S^GU ANJ€ETHAT THE DATE WILL FUNCTION SATISFACTORY.32 Inspector /� DATE .! , [( 4Af/( tit THE MMONWEALTH OF MASSAC USETTS CA= BOARD r L O - i31 LL-vvi 9 JC No laispooal,Plogko jEtottotritrtiatt i ttmit Permission is herebEy�,g�rarr�d. ag , System to Construct ( ` d� •lue f h at No Street as shown on the apcation for Disposal Works Construction Permit NY rant-A I /17"1") DATE FORM '255 A. M. SULKIN, BOSTON d...L,(.S.-B Board of Health ro C-75/ 5 THECOmm N ALTHO . S.. ..'a clppliratiun fur Pisposttl ,.gstrm Qtnnstructiun Permit Sg FEE aro ACHUSETTS MASSACHUSETTS application is hereby made for a Permit to Construct( ) or Repair O an On-site Sewage Dispo.al System Location Address or Lot No. ,�/� /S J Fe t owners Name.Address and Tel.Np. I Installer's Name.Address.and Td]o_ Designers Name:Address and Tel. No. type of Building: Dwelling No. of Bedrooms 3 Garbage Grinder( ) Other Type of Building No per Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow Plan Date Title gallons per day. Calculated daily flow Number of sheets gallons Revision Date Description of Soil Nature of Repairs or Alterations(Answer when applicable) C v O K 8-/BiCd a ■ 'rat Date last inspected Agreement: The undersigned agrees to ensure the construction and maintenance of the aforedescribed on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance ha: been issued by this Board of Health. Signed hail: nrr .✓ a — Date jay ✓ 7 , Application Approved by '!�—r��� � Date Application Disapproved for the followi sons Permit No. Date Issued THEC�//OMMONWEALTH OF/nASSACHUSETTS /112\-2-`�-�'-n``f�GG`"'�`MASSACHUSETTS tertifirate of (Iamplianre TBrCER TI at the D I e SueEhge Disposal System install 7rlepaired/replaced(k) on at ) `ei, � t. ' ' i mr YY at / S I/✓.y-ti- -EC�1.�wyro Lit' c Itclsee uirructed in accordaneeµv�ith1 thy proyis o!of Title-8 and the for Disposal System Construction Permit No dated //11-� ll e f this ter co dii neI pt,coryphange yi tb j pJGVision3 set forth,below: 5 p �i pl to t' Y.0 � {/x'12 _k. nrq' �1�. ��Ca_� T r . 1 The issuance of this certificate shall not be construed as a guarantee that thesystem will function as designed. This Certificate expires o t j /j , y / ? / ) S fit-, rd" DATE Inspector ft( `A7/`j No. THE CO ONWEALTH OF MASSACHUSETTS , . 4.G-r� MASSACHUSETTS !ispasat stem C anstrustian Permit Permission is hereby g(apted to to co rfc({ ) or repair(A) an On-site Sewage System located at FEE and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction most be completed w/itt% 5t o-years of the date below. " �u� ! ____ DATE / ' I ( z / / / / J Approved by FORM 1155 Rev.a n A.M.SULKIN 7(-BOSTON.Mn °'q' /w Aq 7` eV CJn f o';u d y/ AGN p fouvyfsa / C � p-77 p7a/;zy; f/? 1vSQQt // j a>-o cis/O d!urns hoof-I(ag 4WO)0y,;" u04 Ge S/i a.7 cy ay-c.r hF. , a boN 4'n/diVN%J1/24 C /O'wt fY 0q SL_ ,17?8/ P/?'d / rsoa5id _.„_. I ■ i1 V-1 7i t°7 / I D THE COMMONWEALTH OF MASSACHUSETTS / ) BOARD OF HEALTH Gat OF AccrifigtoAlci). ) pplirutinn fur Marks Qluimtrurtinu jirrutit Application is hereby made for a Permit to Construct (x) or Repair ( ) an India idual Sewage Disposa stein at: IL itlesfh.a.n1,ehJ2 t. s /o Lr( Inrmioa. t ate E NaL/Lit Addre Owner or Int No. Zl__Winch._Alv Mf/ 0/027 Address Installer ype of Building Dwelling—No. of Bedrooms 3 Other—Type of Building Other natures esign Flow 3-0 1.1.2. gallons per person per day. Total daily eptic Tank—Liquid crpauty ltCg:dlons Length Width isposal T- - *r--_F. !/g'— Width Total Length al' eepage Pit No Diameter Depth bel ow inlet Cher Distribution box ( ) Dosing tank ( ) ,. / ,O q ercolation Test Results Performed by hi..J:.a }j.+-/L.!L,reb n..1., Date .5-- 23- 1 3 Test Pit No. I lit minutes per inch Depth of Tt [ Pit 6 �1' Depth to ground wate- J10ne Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water lescription of Soil.L' —/L° ICI' Stil QL dOC,f.P ,,,_12' — Y1. SJl/t/ SQ/Y L/ SAf !LL.m Address Size Lot /, POO Sq. feet Expansion Attic ( ) Garbage Grinder (✓) yes No. of penoic Showers ( ) — Cafeteria ( ) flow 300... gallons. Diameter Demi, Ss-lid Total leaching area..- n- sq. ft. Total leaching area sq_ ft Tature of Repairs or Alterations—Answer when applicable .greemcnt: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with fie provisions of Article N1 of the State Sanitary Code—The undersigned further agrees not to place the system in peration until a Certificate of Compliance has been issued by the board of health. Signed application Approved By application Disapproved for the following reasons' Permit No Date Date Date Issued Dam et THE COMMONWEALTH OF MASSACHUSETTS FES../ • c-o � BOARD OF HEALTH %etc:( OF "t Appliratinn for flispnstti Works Cnuunstrurtinn Permit Application is hereby made for a Permit to Construct stmt at: • dd TT{{��''�� �� ���L tiov.e ress Installer Toe of Building Dwelling—No. of Bedrooms Expansion Attic Other—Type of Building No. of persons Other fixtures sign Flow gallons per person per day. Total daily flow gallons. sptic Tank—Liquid capacity gallons Length Width Diameter Depth isposal Trench--No. Width Total Length epage Pit No Diameter Depth below inlet ther Distribution box ( ) Dosing tank ( ) ercolation Test Results Performed by Test Pit No. 1 minutes per inch Depth of Test Pit Test Pit No. 2 minutes per inch Depth of Test Pit or Repair ( -5an Individual Sewage Disposal Ad r Size Lot Sq. feet Garbage Grinder ( ) Showers ( ) — Cafeteria ( ) Total leaching area sq. ft. Total leaching area sq. ft. escription of Soil Y wo-tA. Date Depth to ground water Depth to ground water :ature of Repairs or Alteratipns—Answer yen applicable e� •` low "' it 7 -rr'r at__i!P^- Ia. J `Y „ee-mo,u-LKtA,.� ,greement: 0 The undersigned agrees to install the aforedescrihed Individual Sewage Disposal System in accordance with to provisions of TITLE 5 of the State Sanitary Code peration until a Certificate of Compliance has been iss to —The undersigned further agrees not to place the system in ed by the board of health. fpplication Approved By Signed • \pplication Disapproved for the following reasons Permit No Date Issued Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF @Tertif ratr of htnmplianrr THIS IS TO CE i IF That r vidual ew-age Disposal System constructed ( ) or Repaired ( Y /3 Is been installed in accordance with the provisions of TITLE 5 of The State Sanitary Cod s de4cribed in the pplication for Disposal Works Construction Permit No._-.__-d --f.)-- dated nig')— THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE,THAT THE IYSTEM WILL/F NCT ON SATISFACTORY. ATE 4+ 30/? inspector I � y� wti �nale.�- is t4na.�. iM�Un i� THE COM ALTH OF MAS ACHUSETTS ,q/ BOARD OF HEALTH °U/I //' • r, \ Jo FEE flinpnnat Warku tlnnstrurtinn 1 rrmit Permission is hereby granted s Construct t or Repair 0-1 an Individual Sewage Disposal.System t No . . . � . _ Street s shown on the application for Disposal Works Construction Permit Nop:j IATE DRM 1255 HOBBS a WARREN, INC., PUBLISHERS Board of IIealth