Lot 1 & 2 Applications & Permits THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Appliratinn far fdispnial 3I1nrl Clinantrurtinn 3 rrmit
FEE
Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal
stem at: ��pp � � /� �,QQ
etni =oRsrM...kFiC/
.,. coce.ro�
Insal!er
pe of Building
Dwelling—No. of Bedrooms
f
or Lot No.
Address
Address
Size Lot Sq. feet
Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building No. of persons Showers ( ) — Cafeteria ( )
Other fixtures
sign Flow ,' // gallons per person per day. Total daily flow gallons.
ptic Tank—Liquid capacity[ 'd.gallons Length Width Diameter Depth
sposal Trench—No. Width_cP6t Total Length -3d ' Total leaching are:t-4Q 6 sq. ft.
epage Pit No Diameter Depth below inlet Total leaching area sq. Et-
her Distribution box ( )
rcolation Test Results
Test Pit No. 1
Test Pit No. 2
Dosing tank ( )
Performed by Date
minutes per inch Depth of Test Pit Depth to ground water
minutes per inch Depth of Test Pit Depth to ground water
scription of Soil
dure of Repairs or Alterations—Answer when applicable
reement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
t provisions of TiTn ; 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
oration until a Certificate of Compliance has been/issued by the hcord of hcalth.
tplication Approved By
tpllcation Disapproved for the follow
Si eed
Dats
Permit No O..l..fa
Issued /l nats2��../..��0
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
airrtifirate of Q[omplianr•
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
Installer
s been installed in accordance with the provisions of T1°__: 5 of The State Sanitary Code as described in the
plication for Disposal Works Construction Permit No dated
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
(STEM WILL FUNCTION SATISFACTORY.
4TF Inspector
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
flioposnl Marks Olonotrurtion rrmit
Permission is hereby granted
Construct ( ) or Repair ( ) an Individual Sewage Disposal System
No
Street
shown on the application for Disposal Works Construction Permit No Dated
Board of Health
ATE
RM 1255 HOBBS & WARR EN. INC.. PUBLISHERS
No ii 0 e FEE -.5 Q6
THE COMMONWEALTH OF MASSACHUSETTS
/t. BOARD OF f;H�HEALTH
lam' OF ' M -
Apptirativu far Elisporial if ark!' llattstrurtintt tinmit
Application is hereby made for a Permit to Construct ( ) or Repair ('<an Individual Sewage Dispo:
System at:
,, /
.eti Location-Addu s
t or Lot Na
_
/ o Address
W e.,....a Ivetallcv
Address
UType of Building Size Lot Sq. f
Dwelling—No. of Bedrooms Expansion Attic ( ) Garbage Grinder (
a, Other—Type of Building No. of persons Showers ( ) — Cafeteria (
a, Other fixtures
6
W Design Flow gallons per person per day. Total daily flow gallo
24 Septic Tank--Liquid capacity gallons Length Width Diameter Depth
W
x Disposal Trench --No. Width Total Length Total leaching area sq.
3 Seepage Pit No Diameter.—__._.___ Depth below inlet Total leaching area =q
z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by Date
el Test Pit No. I minutes per inch Depth of Test Pit Depth to ground water
W Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water
0 Description of Soil
x
V
W
ONature of Repairs or Alterations—Answer when applicable...a�� '-/ ,.):4= dN:S�_S4y'
Agreement: as Jf
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance w
the provisions of Article NI of the State Sanitary Code—The undersigned further agrees not to place the system
operation until a Certificate of Compliance has been issit the board of health.
Signed Y– { e
fit- [ --2. y(i
-
Application Approved By `. - :..J� .<af ail 94- .Pi /4 7
bate
Application Disapproved for the following reasons-
[./ p. 7) /' Data
Permit No...L.A O Issued_..J.k.0� � 1,.1. 1�
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
Qlrrtificttte of tamnplittnre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (
Installer
been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the
>lication for Disposal Works Construction Permit No dated
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
'STEM WILL FUNCTION SATISFACTORY.
,TE Inspector
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
fd C..._OF
!! y
33ispnsttl rrnrks (jhnttstrnctinn tirrmit
Permission is hereby granted ....)<;) (
Construct ( or Repair an.Individtal Sewage Disrotal System
jai r
No
FEE 11:A1
street
shown on the application for Disposal Works Construction Permit No.: / Dated....il.n ;..e.. / <.1..<..
rr-erA
Homed re
\TE
RM 125..E HOBBS & WARREN. . PUBLISHERS
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
din/ OF 4/' 724:4717'70 a✓
Application fur Disposal
11
FEN
melts QIIonstrurtion lJermit
Application is hereby made for a Permit to Construct (Y) or Repair ( ) an Individual Sewage Disposal
stem at: tt ,
/,�I/Zt 3K/ /4/%1”/
,
Location Address • pv Lt No.
Owner Address
Installer Address
pe 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
sign Flow gallons per person per day. Total daily flow gallons.
ptic Tank—Liquid capacity gallons Length Width Diameter Depth
posal Trench—No. Width Total Length Total leaching area sq. ft.
epage Pit No Diameter Depth below inlet Total leaching area sq. ft.
her Distribution box ( ) Dosing tank )
rcolation Test Restd s Performed by_Y�//" r- = !fve/7%.!�'s�.�'�G . Date 7 � �_�
Test Pit No. 1 7 J minutes per inch Depth of Test Pit 3 ftil Depth to ground water Al on/a
Test Pit No. 2 — minutes per inch Depth of Test Pit 7P-4" Depth to ground water % A"
scripfion of Soil....f i1..7QPS&'.(Se _S-t.7 _)i CT t &/A•'?
mum of Repairs or Alterations—Answer when applicable
Feement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in
eration until a Certificate of Compliance has been issued by the board of health.
Signed.
>plication Approved By
)placation Disapproved for the following reasons•
Date
Date
Date
Permit No Issued
Date
Fax
THE COMMONWEALTH OF MASSACHUSETTS
,BOARD OF HEALTH
l , / OF /06 Iigkfi✓ /0
Application for Uinpu0a1 Wurt w Cnunutrurtinn jfrrutit
Application is hereby"made for a/n Permit to Construct 1.,(. ) or Repair ( ) an Individual Sewage Disposal
ystem at: 4 FL✓<, _t /`1 /CA r° / ..
1st No.
c
X<��+ toy .&
iv(TA
4, 4_01_ 1
Installer Address
ype of Building Size Lot 'SSq. feet
Dwelling—No. of Bedroom Expansion .Attic ( ) Garbage Grinder ( )
Other—Type of Building _T9i&t'LS No. of persons f O. Showers (4J- Cafeteria (/tid
Other nes _a2 1-9• i cn.&EicA,Ce .tgrT.
esign Flow gallons per person per day. Total daily flow A..1 so gallo ,
eptic 'rank—Liquid capacity/ODO.gallons Length Width _.. Dianeter Depth 4F_
isposal Trendy No / IVidth__f)?0 Tom Length 4 a Total leaching area_6Z7 0 al_ ft_
eepage Pit No Diameter Depth below it tt Total leaching area sq. it
■they Distribution box (r) Dosing 'yy'Nt//�r�p�
ercolation Test Results Performed by W. r Date 3 3 - %(•
Test Pit No. ] minutes per inch Depth of Test Pit 36 r' Depth to ground water. ....N._tm¢B%-
Test Pit No. 2 minutes per inch Depth of "Lest l'it Depth to ground water a yrr,
Address
'escription of Soil risttf= d?LVlr`t- S .o „f ad* t'4- S, - 324 i7
3-
<1.3C`f -4n-wi X O
Sec o
[attire of Repairs or Alterations—Answer when applicable
greement:
The undersigned agrees to install the aforcdescrihed Individual Sewage Disposal System in accordance with
to provisions of Article N1 of the State Sanitary Code—The undersigned further agrees not to place the system in
aeration until a Certificate of Compliance has heen is by I e 1 _r I �f health.
/Signed
.pplication Approved By
,pplication Disapproved for the folowiny reasons'
3 -/6 - '76
Date
Permit No
Date
Date
Issued
Date
DEEP SOIL LOGS
WNW( 44Ofy 14 live 77--
:ATIOI•( by Five..
GiuN9 WArmk G, '6 "
T
t
ti
aotl„olwntcrc
DerE 8- /3 -x
cowaym
n
v
GeQom WArne
U.,
n TP
1
STOP F(.6 � H r16Ce
1
2 K67Ci: ` r. LOCno,.3
_ c1 r O !
�RO f0Sr 0 &a.„iAll: Jr-wIAGG i
i l^1 i
�yiSpoaa” Sy' Jl . . ,P ■ I
'Atte oR \ '°" E `
A F� E e ,1
A vJnitte C .c _67-S? fr61Q 12 nNdic, ,7 ;AI rece A r7of E-r-tv7.3 I 1 F 1 j< °2L
&-,A7 Oil' , (SS J 1 ! '
e •6 .---
1
_ - 1
i` 1
bSnm,•-.'G IY) n: ,Li .,v„ Vs.l: �, C , Zo.-:
No !'- FEE
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
2Y OF LbfA'An::�.v>ti6't!
.Appiiratintt fur /aispnsai illnrl iiio Tutuitrurtinu hermit
Application ip hereby e for.aalaer�mn//t�o Construct (' ) or Repair ( ) an Individual Sewage Dispt
System at;-- L d ff?I )s &j - lht.k_ ,et-
_
Pit is c .„ , : .cr.&.ss at awl ( / onzE" *�") /L ., cat
r oft" Address
.4.4:4(t4 etstri sal
q Installer Address
y Type of Building Size Lot Sq.
U Dwelling—No. of Bedrooms Expansion Attic ( ) Garbage Grinder (
p`it Other—Type of Building No. of persons Showers ( ) — Cafeteria (
COther fixtures
Design Flow (. gallons per person per day. Total daily flow gall
Pa
• Septic Tank—Liquid capacity 00 gallons Length Width Diameter Depth
xDisposal Trench—N9 Width Total Length Total leaching area c
5 Seepage Pit No ( Diameter Depth below inlet Total leaching area.YQ'y BSq
z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by Date
,_I Test Pit No. I minutes per inch Depth of Test Pit Depth to ground water
W Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water
Pi
O Description of Soil
U
W
UNature of Repairs or Alterations—Answer when applicable
Agreement:
The undersigned agrees to install the aforedeseribed Individual Sewage Disposal System in accordance h
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the systen
operation until a Certificate of Compliance has been issued by the board of health.
Signed[ G .. Cr✓.,/- --
4- s-if-C //'. 11CAw Q;t nue f
Application Approved By ->4,�- `f.. ;y. i /`Tb.[✓+� at_ !.
U oat.
tts
Application Disapproved for the following reasons'
Date
Permit No �-.j) Issued-.t d / i` y
Si Data'
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
fin-filtrate of Tomplfttnre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
Installer
as been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the
aplication for Disposal Works Construction Permit No
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS dated
GUARANTEE THAT THE
YSTEM WILL FUNCTION SATISFACTORY.
ATE
Inspector
I"
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
CP
P�tLS}tAaMI Ithirjts (tunn5frurtio t ¥rrm[f
Permissiol,y,,,(�'ierehy granted Li-C'.C'2-drn i%'_,p,aten
Nonst uct or .I air ( ) an I vi al Sewage Disposal System
FEE
shown an the application for Disposal Works Construction .l}Intit No I
TE k.-a-rt l 7% I
M 1255 HOBBS a WARREN. INC., PUBLISHERS
Dated>``i a Y /71 j7
Board of Health ��
No.S.7,7
THE COMMONWEALTH OF MASSACHUSETTS
A BOARD OF HEALTH
OFP Ltitil..
Applirnfiun fnr'lfliopnsttl c nritE n
nstruriintt IJertnif
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
FEE ,:_i
Type of Building Int et
MdeL
Dwelling—No. of Bedrooms Size Lot Sq. feet
Other—'L e Expansion Attic ( ) Garbage Grinder
Type of Building No. of persons
( )
Other fixtures p Showers ( ) — Cafeteria ( )
Design Flow gallons per person per day. Total daily flow
Septic Tank—Liquid capacity gallons Len h gallons.
Disposal Trench—No. Width Width Total Diameter Depth
Total Length Total leaching area s ft.
Seepage Pit No Diameter q,
Dther Distribution box ( ) Dosin tank
Depth below inlet Total leaching area sq. ft.
Percolation Test Results Performed by
Dosing ( ) q
Test Pit No. 1 minutes per inch Depth of Test Pit Date
Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water
Depth to ground water
)escription of Soil
Address
Iature of Repairs or Alterations—Answer when applicable
.greement:
The undersigned agrees to install the aforedeseribed Individual Sewage Disposal System in accordance with
Le provisions of Article Xl of the State Sanitary Code—The undersigned further agrees not to place the system in
teration until a Certificate of Compliance has been issued b�j th oard ooff,health.
Signed.. l,f� j C •
pplication Approved By
pplication Disapproved for the following reasons
Date
Date
Permit No -S7 7
Issued
Date
l.k.,:..Jg73
y
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
Olrdffirnfr of (IInm;tliatur
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
Installer
as been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the
pplication for Disposal Works Construction Permit No dated
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
YSTEM WILL FUNCTION SATISFACTORY.
ATE
Inspector
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
V V
Disposal arks (11 nsfructinn tinntif
Permission isecereby granted -
Construct (' ) or Repair ( .) an Individual Sewage Disposal `Sys
No _F.,._3...—v.r..:,..r^fitr:m
shown on the application for Disposal Works Construction Permit No. Dated
•
TE
tM 1255 HOBBS & WARREN. INC.. PUBLISHERS
oard$f Beall