HomeMy WebLinkAbout0070 BAY LANE - Health `0,Bay Lane
Centerville d?r
A = 186 - 036,- 004
SMEAD
No. H1630R
UPC 10259
smead.com • Made in USA
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THE COMMONWEALTH OF MASSACHUSETTS
BOAR® HEALTH
......OF........ . ..........
��.' .5'uT T 1 ..........._.
, 1pplirtttaun for Uaupuual Workli Tunitrnrttun ramit
9- Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
-------------------- -
Locati dress o t N
a Owner 1R`L1r1 1Addres
J - d--- ---. . .--• -•.... .. ......... .............
- ---------
Installer dress ..............._..
r
v Type of Building a Size Lot.0a6' C . ....Sq. feet
�., Dwelling—No. of Bedrooms___.......�.............................Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building No. of persons............................ Showers
a g --------•---------------••-• P ( ) — Cafeteria ( )
Other `fixtures -----------------------------------------------------
W Design Flow.-------.•.1 ......................gallons per- pe y. Total daily w--------.---*...........
...�__.�....-.............gallons.
i
WSeptic Tank—Liquid capacity --.gallons Length._-.....-_---.. Width..'.=S_... Diameter__.___•.-___._._ Depth.. '_ .1:_
x Disposal Trench—No. .___..%�-....._._. Width_..- -_-___-__-- Total Length.....tl.a....... Total leaching area___-/_2-..sq. ft.
Seepage Pit No--_-_------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ()) Dosing tank )
a Percolation Test Results Performed by., �� N....Q'!h! ........................... Date.. ___�� ._��
�... ........
e. ..
Test Pit No. 1---`—._ _minutes per inch Depth of Test Pit./� ..... Depth to ground water--_____��__.2..--._..
fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
-------• . ......................................................................
Description of Soil..jQ_`.............................. s.._._.
x ....---•- ---•- i� -S G,�--`----------------------•----------------------------.-------------
U --•-..
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 i i . 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has ben issued by the board of iealth.
/(
Signed----------•••••-•-••-----(�._.�F._---9l -- zillin
-----------------....-• ....
/� 1 ate
APp ication App ed By.._.. ----.�' �j'--------------•%%�% "' ....���&-----•-•--•---
Application Disapproved for the following reasons:..................................................................................
. Date................
......-•--•-•----------------•--------••-----------------•---------------•--•-----------...-------------•-•----•---•---------•----•--•-•-•---•...•-----•-•-•---•-----•-•-------......-•--•--•----------
Date
PermitNo..............................................----------. Issued.......................................................
�r— — Date
Fps. .... ...
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® HEALTH
1...0.E /..'U.......OF....... /�. .N..rT! l .C:.sue.............
Appltration for Diipuual Works Tunitrurtion Prruld
Application is hereby made for a Permit to Construct (�4 ) or Repair ( ) an Individual Sewage Disposal
System at: /
Location-Address or Lot No.
--------------•---------•---•---.._..........................__..._.............._..........._.... ..._..._...................•••---••...............---.............•---....................._.....
Owner Address
W
Installer Address
Type of Building Size LotZe,�`J_-._�J--....Sq. feet U
,., Dwelling—No. of Bedrooms.___._......................................Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ............................ No. of persons....-....................... Showers ( ) — Cafeteria ( )
Q' Other fixtures --------------------------------
¢ // ------------------------------------------------3 -G----------------_______--_--
Design Flow............ _____________________________gallons per sen$er day. Total daily flow__..._................._....._ ........gallons.
WSeptic Tank—Liquid*capacityN�O�.gallons Length_G_�_l�.--- Width.*.2q. Diameter________-___-- Depth•-��.`1_..
x Disposal Trench—No. ......of ........... Width._4............ Total Length....5.;eCJ_...... Total leaching area....1,6_.U_...sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box (X) Dosing tank ( ) /
'-' ./7L�N.....�N
Percolation Test Results Performed by S.•--•••.•••••.............. Z ?� 7
----•••--• Date•. ........
Test Pit No. 1..E._.?-..minutes per inch Depth of Test Pit./D B..__._ Depth to ground water-___-_
G, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
W . ...................--•• _...--
x Description of Soil.. _ ••---------•----•----------------•-•------•---------•------
(� ••--•-•-------••--•-------•-•-•...••-•-•......-•-••-••.
W ..`
UNature of Repairs or Alterations—Answer when applicable__r...........................................................................................
----•--••••-•---•---•----•-----•---•••-•---••-•••••------•-•----••-•--•••...............•---•---••---••---••-•-•-----------------•--••------••--------•-•-•-....-•-•---••--••---•-•-•••-•-•••.....-•--•-
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of'TTIE 5 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 board of health.
Signed----------••-----•-•--••----------------------------------------•••-•-•--••---•--•-
;�'1 '�'� -- ----......--------..............
Application Appro, ed By---••--- "...�,.0o0.._.._✓"� ��21!�, e..............----------•--•--------------- - Date '
Application Disapproved for the following reasons:...............................................................................................................
..-----••-•...............•--------•----.....----•-......-------------•------------......--•--------•----...------•-----••-------•-----------•--....-•--•---------------•••-----•-------•--•----••---•--
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...........................OF.....................................................................................
Trrtgfirtttp of Toutpliattrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (x) or Repaired ( )
by.. '.7 ' ... ""u 1 -------
nstal -----------------------------------------------------------------------------------------------
In
-----------------------................................................ s
has been installed in accordance with the provisions of T . T_ 5 of The State Sanitary Code as described in the
_ V.application for Disposal Works Construction Permit No ....I ............. `e dated_...-___-__..._..._______a_--------------------
THE ISSUANCE OF THIS CERTIFICATE SHAL OT BE CONSTRUED AS A,GUARANTEE'T1 AT t,HE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.................................. Z'e Inspector..., .......................
p }
THE COMMONWEALTH.OF MASSACHUSETTS
f,
BOARD OF HEALTH
/U.l'1/.............O F.. ./�I.11.i�!I.T..�4. ..................................N .../ FEE.. .(1_ ......
wtulioual Workii Tonutrion "[rruttt
Permission i hereby granted L �..._ - ............................
to Construct ( ) or Repair ( ) an Individual Sewage Disposal System
atNo...........Z-•V.�Z........ ---------------2�,4.Y..._......eI V- ------- C...... r. `-----------------....----------------------------.........
Street
as shown on the application for Disposal Works Construction Permit No................... J)ated..........................................
A�ar� -alth------------------F•-----------------------
DATE..............�--._'�-v���..--------•----•--------- __ e
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS r
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CERTIFIED PLOT -PLAN_
MASS.
I CERTIFY THAT THE R. -J. OWEARN,./NC, RLS,, RS
SHOWN ON THIS PLAN HAS: BEEN 1348 ROUTE 134
LOCATED ON THE GROUND AS INDICATED. EAST DENNIS, Mass.
DATE: ; 7f 8 SCALE:
JOB NO:SZ-114 2 CLIENT �3 uL < � -_
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LEGEND , ,
EXISTING SPOT ELEVATIONS O,A
EXISTING CONTOUR—-- 0
FINISHED SPOT ELEVATIONS
FINISHED CONTOUR 0 PROROI Ox
APPROVED= BOARD OF HEALTH V 1,G '
it TE
i CERTIFY THAT THE. PROPOSED, R. . QH 'ARl x.
BUILDING SHOWN ON THIS PI-AN'
CONFORMS TO THE ZONING LAWS EAST DEN �tl�t ►` fiy'
OF , MASS. , DATE ALEJOB NO. 8/ LQ02 Ct�`{ Nrt h:
DATE REGISTERED LAND SURVE OU DR. BY
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<<, - ACTUAL ' SIZE F SEPTIC TAN TO� BE INSTALLED.... 10 GAL,
0 _ .
LE _ tl ►REA REQUIREMENTS:
Stti?E Wie11_L A 6i41. ,lgf
LEACH Nf:�. CAPACITY ( BOTTOM"►- IQfWALL �.:.• -
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f
5l4 GAL
f 8ox/. Zoio �
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RESERVE LEACHING CAPACITY.. . . . . . . . . . . . . . . . . . r. RICHAW
• . L JAMES
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TO:P ,OF .. , Imo_ �E�a .
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UN
ELE�/:�/3:0p /rr ni,v. CONCRETE ' 4 SCH. 40
COWERS PVC PIPE
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_ MIN, PITCH 2"L4YER OF •
CG E,qN SA/VO
,:. 1/8 PER. FT.
a /2 w.4 ED
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_ 1 MAX.
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FLOW LINE
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y 9.3 CMFIEARN -•i
4" CAST IRON g -�-L 4e �F sTE�`�'{�p�
PIPE- MIN: PITCH - O SEtRW�
I/4 . PER FT. �I$T
BOX s BOG 4 GAL vim« rE,ev ic�F
SEPTIC
MAS S.
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TANK
P R. J: 0 HEARN, INC., RLS, IRS.
t 1348 ROUTE 134
EAST DENNIS, MASS.
PROFILE OF Glto,.UND WATER TA9LEt.;. Ec.=40
JOB N0:/oo Z CLIENT•
SEWAGE DISPOSAL SYSTEM
NOT TO SCALE DATE SHEET Z OFZ