199 Title 5 Application/Permits 1987 No
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
Fax
Appliratiun fur 33i0pimal 11`Turku (Eunntrurtivn rerntit
Application is hereby made for a Permit to Construct (xm) or Repair ( ) an Individual Sewage Disposal
System at:
MABLE—ItilaG.E...RDAD J.,QT 11.1.9
Location.Address or Lot No.
RDI3.ERT. GOODMAN D.LiD. .SDUTIL StTREET.,.. QRT.MNP.T.ON.,MA.
Owner Address
Installer
Type of Building
Dwelling—No. of Bedrooms 3 Expansion Attic (
x
n4
0
x
Other—Type of Building No, of persons
Other fixtures
Design Flow 55 gallons per person per day. Total did
Septic Tank—Liquid capacity 1500 gallons Length 10 ' 6" Wdth I
Disposal Trench—No. Width Total I.ength
Pit 1 Diameter Depth below lute 1- 92
Other Distribution box (,,,, Dosing,tank C )
Percolation Test Results Performed by PnARMER ENG. CORP
Test Pit No. I 2 minutes per inch Depth of Test Pit 9 Depth to gro
Test Pit No. 2 ninutes per inch Depth of Test Pit Depth to
TEST PIT #18
0-10" TOPSOIL
10-34" SANDY SUBSOIL
34-108" MIXED FINE—MED.SAND W/SILT
Address
Size Lot 137, 562 Sq. feet
Garbage Grinder (x )
Showers ( ) — Cafeteria ( )
Seepage P t o
y flow
Diameter
Total leaching ar
474
Total leaching aret
330
_gallons.
Depth 514"
sq. ft
sq. ft
Description of Soil
Nature of Repairs or Alterations—Answer when applicable
AgreemThe undersigned agrees to install the aforedescribed individual Sewage Disposal . stem in accordance with
ent:
the provisions of Article X I 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 hoard of health
Signed
Application Approved By
Application Disapproved for the folio wing reasons-
Permit No
Issued
Date
Date
Date
Date
N -37
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF C....1-TH
L, 0 F dhtl?
Eirka mitt ration lirr7t
Permission is hereby granted
to Construct/ ( oepair ( );ni "dual *wage Disposal System
at No
Street
.
as shown on the application for Disposal Works Construction Permit 347 Dated /alt cf7
-.434-0I1C4 ca5-
DATE M-4-C- 7 1W Bo of Health
F e
ni r,Silk citY \
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
mad-4 -,
Iq9 iSl"Y::oF'HrJRTI-{AMPTOia:_......_._.........._._...
of innyltatttr
hierttfuate stun constructed (� or Repaired
CERTIFY That the a�'yidual Sewage Disposal Sy --,_�___
THIS S A.1_..._C.-,Q.dJ/..114:241--.------...:
"_ G m.w�a ' ..�242fs�1]1CPL1�Cod the in// - of The State Sanitary
accordance with the provisions of TITL?Ep 5 ...-_-----
s. .5-_$--y - _ dated......Icy,. .-7
Works S CERTIFICATE Permit No LL N iN
' application for Disposal THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUAR ANTEETH AT THE
THE ISSUANCE OF 7N SATISFACTORY. Inspector - -""--"
-13,..12 ------ - ,