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HomeMy WebLinkAbout0032 DOLAR DAVIS ROAD - Health 32 Dour Davis Road A = 171 --205 Centerville EM E A D No.2-153LOR UPC 125U smead.com • Made In USA g OIN �� ' :5 �` No..V._-�__`��_j FtB_...........�.......... THE COMMONWEALTH OF MASSACHUSETTS ' BOAR® OF HEALTH ............OF......... )<Z ti(� r1 ............................. Appltrtt# u for ' io U n�al urk,i Tamolrurtinn rruti# � Application is hereby made for a Permit to Construct (" ) or Repair ( ) an Individual Sewage Disposal System at: P.U� l� D 0 la 1PA V 1 S � C�c9J V 11�,. Locat•on-Address r Lot No. _LV ................l-1.,>�nS......1..'.-.-�•- �' /)s \S ..:..............•- -.......--- Owuw dress .... Installer Address Type of Building Size LotA_9�j.7_+_._._Sq. feet Dwelling—No. of Bedrooms................................._..........Expansion Attic ( ) Garbage Grinder VO 'k Other—T e of Building No. of persons____________________________ Showers — Cafeteria Q' Other fi tures ------------------------------•••- W Design Flow_________ _..........................gallons-per person per day. Total daily flow.......... _e..................gallons. WSeptic Tank—Liquid capacity�Mq..gallons Length__-�11:2_ Width................ Diameter________________ Depth................ x Disposal Trench—No_____________________ Width_____._j.................... Total Length.....................Total leaching area....................sq. ft. Seepage Pit No-------_____________ Diameter........t<?...... Depth below inlet.... Total leaching areal—C. ..sq. ft. Z Other Distribution box (V/) Dosing tank ( ) Percolation Test Results Performed by____ i........... Date___._(t)_ Test Pit No. 1_ Z_..minutes per inch Depth of Test Pit.... ________ Depth to ground water____'-______...... Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ►x ----•-•----•........................•-•------•------•-•------•f------•-_-•••• ........................................... -----•--• •-------....----.._... ODescription of Soil---- 7-__.- HQ 0 1_ -- 7 ....................... _ V 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 TI'i 1E 5 of the State Sanitary ode— To undersigned further agrees not to place.the system in . operation until a Certificate of Compliance has b e ' ue t oard of health. x H),gne, •-- ••............... ------ PPlic on Approved By-•••----•---•-• •----••_._ ... -----•--- ----------- to ---------------------------------------- Date Application Disapproved for the f oasons---------------•--------•----•--•----•-------------=-----------•-------------•----------------- .......................•--•••-=--•----•---•--•-••---••••----••-•---------•---•---•...................................................... •••-----•---••-----••••--••-••-------•--••-••--------•-- Date PermitNo......................................................... Issued_....................................................... Date No.. �_° Fxs.............................. ql THE COMMONWEALTH OF MASSACHUSETTS 6 BOARD OF HEALTH p ' .............0F........ T� ''� ....................._.. Appliration for Bi"vsal Works Tonstrnrtion ramit Application is hereby made for a Permit to Construct (v ) or Repair ( ) an Individual Sewage Disposal System at: t , .... •......................... ...-•-•----................................. Coca ion-Address or Lot No. L.���� �... ,�S ..'!?'Z .......:1T---- tJ S ....................................... O er a dress a Installer Address Type of Building may, Size .....Sq. feet Dwelling—No. of Bedrooms.....___✓__..................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building •___________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures --------------------------- •. W Design Flow......... ---------------------------gallons per person per day. Total daily flow........... ...o.................gallons. WSeptic Tank—Liquid capacitv4.0!�L.gallons Length__ _- Width---------------- Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area____-_--__-_-------sq. ft. Seepage Pit No---------------- ._ Diameter....... S;�t...... Depth below inlet... _........... Total leaching area ___.___sq. ft. Z Other Distribution box ( ) Dosin tank0-4 ( ) Percolation Test Results Performed by.__.__ ___.__._ -___ ............ Date____ .. w tl�L i Test Pit No. 1 � .....minutes per inch Depth of est Pit----'Z I......_.. Depth to ground water..... .............. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ =- - ............................................................. O Description of Soil.... '--Z'... r' V©ram ` !L-/r Z ..A 1...T7 h. -!�-- l-' v •--••-----------�-------- G --�-'-N----- %�--_-a._�_►.3_---7'�- ------------------- 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 TAITLE 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�y therboard of health.. Signed i b ` Il/. �_,r-s!' ...................•-------••---••••--•-•• - /_ U ?" e PPlication Approved'By---••-------- -, --•--- Date Application Disapproved for the f .owing reasons:---...•---....._•---'..........................................................................----•------••. ....................•_......._.......•--•............----------•--••------••._.-•--•-......._•------•-•-•-•....._........----••--•-----••••--•-•-••-----------••----••-•------------•-----_.._.......... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1-2 /.........................OF.. 1¢. µ f .�,� �- (Inrfifiratr of Tontlifi�tnrr THIS.IS TQ CERTIFY, That the Individual Sewage Disposal System constructed (�or Repaired ( ) by.. '` :_ ° -'.' , .__.. a'y�O - �= ,$ .i.�............................ '^ i x Installer ^� ............................................ .......... has been installed in accordance with the provisions of TITLE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No...... -5------1.-L1._ ....... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONS RIDE® AS A G)VARANTEE THAT THE SYSTEM WILL F�IJ CTI N SATISFACTORY. DATE !V... . .. ........... -•--.._... Inspector............ THE COMMONWEALTH OF MASSACH ETTS\J , BOARD/,OF HEALTH Nz. -:•'.__........ FEE........................ Disposal Works Tontr ion amit ✓ �,✓ /" -- Permission is hereby granted.....Z z--•`f '..,t' :.__ = _' '� �-/'•?� '� �j `�' `-•-•--......•.........•----...._. to 'Constrikqt f j or,Repakr ( ) an -idividual Sewage Disp sal System atNo... - r._ -_ 1 ' r ....._..._f. '. /'-- - . ................................................ Street as shown on the application for Disposal Works Construction-Permitl- _ .,�� D'ated_._� _ _,t" _ . ry �tV-------- ....%� Board of Health DATE...=- -•---•----•-••--------------••-------•-------- FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS f SITE PLAN SHEET / OF 2 SCAL E: l ti rcg KV A-%SA h t►•� �---�.` I71h't".$OlL- 51 X �j 0 � aft fi 1A 1 — I o � � � r N 1 � N d bL 81 x 5 2 , WILUAM M: ✓' <v WARWICF! ! NO..j9771 '/.G'tiistJ FOR 1..lr_ L.-LL�.I REGISTERED LAND. SURVEYOR ZONE G PLAN REF. DATE BENCH MARK DATUM �''``''w M r� WM. M. wA RWICK 8 ASSOC. , INC. DOMESTIC WATER SOURCE 't"a`�t'j wll"r0 _ BOX 801 - NOR TH FAL M041TH FLOOD ZONE.' 1-�t1�Z,c�.t�D aG� MASS. 02556 - (6I7) 563 -2638 ,.... LEACHING.ACHING. 8A5/IV SECTION NOT TO SCALE Shac 1< 2 a7" z 24 C./MH COVER ' RT EAH F/L L � BRICK AND MORTAR COURSES AS KEO'D• TO BRING COVER TO GRADE i 4 B"FLOW L/NE INLET _ _i' y: p"_y"TO�"WASHED PEA$rONE FREE. OF'IRONS, � .� P/PE T; FINES AND OUST IN PLACE OPENING WITH 4%g." •. ��4 TO l;V WASHED CRUSHED STONE FREE Of i I OUTER DIAMETER IRONS, FINES AV (X/ST /N PLACE AND /•'14"INS/OE " DIAMETER I. CONCRETE TO BE 4000 PSI 28 DAYS 2. REINFORCED WITH 6%6° NO. 6 GA. W,W.M. 2'AND 4 SECT16NS ARE AVAILABLE FOR GREATER DEPTH REQUIREMENTS 4,0;, �— 2�- --60"—�-�-- 2�--� 4. NUMBER OF PITS REQUIRED ONJ; MIN. lo --I EfFECT/VE DIAMETER NOTE: EXCAVATE TO ELEVATION *�.00R 6 (Nor TO EXCEED a TIMES EfFECr/VE DEPTH) LOWER AS REQUIRED TO REMOVE ALL WATER TABLE -- LOAM AND CLAY BENEATH PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN- 7'YP/CAL PROF/LE GRAVEL TO DESIGNED GRADE. /B"STD LT. WGT. C.I.MN COVER %IN6 E 4"B/T.F!B£R P/PE TIGHT JOINT OUTLET LEVEL DWELLOW LINE 70 FIRST JOINT14 O O110 0 1 c.I. TEE5 �92 110 I �o 11 11 o08 00 1 1 STD. PRECAST CONC. 1 1 0 0 0 0 1 1 1 1 �9 IST. OX TO BE '��O OOOGAL.SEPTIC TAN -- 1 11 100 00 01 1 I INST4UED ON LEVEL, 1 p 00 0 STABLE BASE 1 0 0,1 1 i 11100 0011 • Ng4rlC TANK TO BE 1 11100 0 0 1 11 1 INSTALLED LEVEL, 1 11 100I 0 0 it , ; STABLE BASE. floo } 1 1 p Q O O 0 1 1 L EACH/N6 BASIN p BASE TO BE LEVEL : 1 i j b 0 0 0 1 1 ; , . 10 , SOIL AND PERC. DATA PERC. RATE : G MIN. /IN. O„ TEST PIT NO. P3-7 79 0�� TEST PIT NO. 2 ��Jt,±c t-f�t,17 Z1 'rv-P /5v Aso�L TEST BY WITNESSED. BY TEST PIT GR. EL._2 .._ MD- DATE II Igo (a�ND.wAr� DESIGN DATA GENERAL NOTES BEDROOMS NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. DISPOSAL SEPTIC TANK, DIST. BOX AN LEACHING BASINS TO BE STANDARD EST: TOTAL DAILY EFFL2�GPD. PRECAST REINFORCED CONCRETE UNITS. SEPTIC TANK 100 0. GAL ALL .SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE Z TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE, S10EWALL AREA GAL./SQ.FT. MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF BOTTOM AREA'..i ,.GAL./SQ.FT. SANITARY SEWAGE EFFECTIVE ON JULY 1 , 1977. LEACHING REQUIRED_�79 SQ.FT., ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD ACTUAL LEACHAN6:ARE b OF HEALTH. t- 207 0-FT : AT -COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. PITCH ALL SEWER LINES y4, / FT. UNLESS INDICATED OTHERWISE. OF SEWAGE D/SPOSA L SYS TEM ' •�03' MARTIN � 1����� ' �� 1_Lc� �✓MORAN- a�i LOT (0 D A V 1 D 023417 ��Fss/ LNG OlJAI SCA4f AS INDICATED DATE Z �_a.4 M'AI, Al. WARWICK d ASSOC., INC. ®OX 801 - -NORTN fA44OUTN MASS. OZ,566 - to?) 565-P658 PROFESSIONAL ENGINEER r s 'L0 CA ION � S EW A u E Pe NMI NO. VILLAGE INSTALLER'S V, AME AD0RES5 5 U I ! D E R Dl OWNER og DATE PERMIT ISSUED DART £ CnMFLIANCE ISSUED �i 2 t. ff 377 G �G rr 3� 6 cl- VILLAGE 0P5 "rA LLER'S NAME Z ADDRESS a u I L D I R 0 OWNER C2 af-L - SOAJ oas � D A T F Pis ISSU ED a 15 gam__-_�_ DATE C0MFLIANCE 15SUED i \o� G 8tG�r 3