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Home My WebLink About0132 FOX HILL ROAD - Health 132 Fox Hill Road, Centerville = 1)0 - 044 - 002 _..�_ -- _ — _ — ------- --- -- _. --- - —_ -------- --------- - _— -- ---- -- -— ----_ .- - - - Sm UPC 12534 No.2153LOR MA�T�Np�.MN 4 ed.�...::�..:..,.....�......a....r,..�.u...atrullu�:ruWu.fe......:..u�J1�1..i�.su.........�..._:..-.,Ja..a-.. �_:..au....re.,._�:-...:r....�._:.w.... .:...— ...<.........._ ... ...�n„ui..:� �-' r._ ..ter-..... _ -,.. ...�.- �_,u�.r.�.. _— _ _ .-....-_......... .� �� I `_) � V � No. Fee V Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS / 0(ppYication for �Die;pooar *p6tem Construction Permit Application for a Permit to Construct(-O Repair( )Upgrade( )Abandon( ) El Complete System El Individual Components Location Address or Lot No. ` p X bf f A 10 4(` �e h l L 6-s n i ij� Owner's Name,Address and Tel.No. 0O� n'llL Assessor's Map/Parcel 1 Installer's Name,Address,and Tel.No. 'U'tj h)r=,S lye L kFl: Designer's Name,Address and Tel.No. -7/- 2yZy Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow g3 a gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank ldod 4—At Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer w,he f pa plicable) Z Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described 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 Certifi- cate of Compliance has been issue this I V Health. Signed Evil A 4A4 Date Application Approved by ® Date Application Disapproved for the following reasons Permit No. CIIJ Date Issued THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS f 2pplication for �Digogal *pgtem Congtruction 30ermit Application for a Permit to Construct( ')O Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ? 2 p "'I �b Owner's Name,Address and Tel.No. Ns Assessor's Map/Parcel q 0 „C)1 Installer's Name,Address,and Tel.No. -TA I"F S w 9 L K FP Designer's Name,Address and Tel.No. 7 2 ( F 09C w.a.f 4 K 0 kl YR A 4'" VV- 2- 'Z y Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 1606 6-oc Type of S.A.S. Description of Soil Nature of Repairs or Alterations Answer heu applicable) hdl b 94 k 1� L,cJ`ffh Date last inspected: F, Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described 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 Certifi- cate of Compliance has been issue this Health. Signed VarP C Date 1 ' Application Approved by /Z Date 10 f' Application Disapproved for the following reasons �. Permit No. Date Issued = THE COMMONWEALTH OF MASSACHUSETTS *; BARNSTABLE, MASSACHUSETTS ' = Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( x)Repaired ( ) Upgraded( ) Abandoned( )by at een-constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. — dated Installer 77A 1�7 F J k fAC 1-P/3 Designer The issuance of this permit shall not be'construed as a guarantee that the syste will function as designed. Date 16 —,3D- 27 Inspector M �— No. V� --------------------------Fee l �_.._. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS lwtgpogaf *pgtem Congtructton Permit Permission is hereby granted to Construct( -1 pair( )Upgrade( )Abandon( ) System located at 132 For 1,,,// X L rkl4y r v111e 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. Provided:Constniction must be completed within three years of the date f tW�Prmit.Date: Io - !� Approved byC/ r i 10/9/97 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) 1, hereby certify that the application for disposal works construction permit signed by me dated )b /i - `� , concerning the property located at )J 2 F®x#1// R n meets all of the following criteria: • There are no wetlands located within 100 feet of the proposed leaching facility • There are no private wells within 150 feet of the proposed septic system • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • If the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.I.S.map) B)Observed Groundwater Table Elevation(according to Health Division well map) SIGNED : ,, all, DATE: 1,4 --JS' 9f LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. q:health folder:cert i TOWN OF BARNSTABLE LOCATION _1-72 SEWAGE # -Y8 Sv VILLAGE ASSESSOR'S MAP& LOT 1 D- D(/ eo; INSTALLER'S NAME&PHONE NO. -J' L✓Iq L If E it T1Q 7`l�-2 Xj Y SEPWIANK CAPACITY G-qL LEACHING FACILITY: (type) lei (size) /vm a e.� NO.OF BEDROOMS "-BUILDER OR OWNER c a AOlz PERMITDATE: I n COMPLIANCE DATE: 10 Separation Distance Between the: Maximum'Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site orwithin 200 feet of leaching facility) Feet i Edge of Wetland and Leaching Facility(If any wetlands exist within:•300 feet of leaching facility) Feet Furnished b' -------------- O �i 7-5 F-S TOWN OF BARNSTABLE C�T H E TO o OFFICE OF DAHa9TABL i BOARD OF HEALTH y NUB. Op t639. `� 367 MAIN STREET �o MAY HYANN IS, MASS.02601 June 20, 1997 Mr. Michael McGonigle Mrs. Mercy 132 Fox Hill Road Centerville, MA 02632 Dear Mr. & Mrs. McGonigle: You are granted permission to install a six feet by six feet leaching pit in the designated reserve area as shown on the engineered plans dated July 29, 1995, revised October 10, 1985. This permission is granted because you, Mrs. McGonigle, testified that the cost to strictly meet the new Title 5, regulations is double the cost of installing a leaching pit ($3,000 versus $1500). You testified that you do not possess the funds needed to install a large soil absorption system. Also, there is limited space on this property. If a large soil absorption system would be required, it would be located within 100 feet of Fox Hill River. Sincerely yours, Susan G. Rask, R.S. Chairperson BOARD OF HEALTH MCGONIGUW P/Q TOWN OF BARNSTABLE -7 LOGA7116' I-72 Pox&,/f Ah SEWAGE # VILLAGE ASSESSOR'S MAP & LOT D-Q� e®� INSTALLER'S NAME&PHONE NO. l i /119 L k e 9 19 7711-2 Y2 Y SEPTIC TANK CAPACITY n G-#L LEACHING FACILITY: (type) f i f (size) /V v NO. OF BEDROOMS BUILDER OR OWNER PERMTTDATE: I n — )� '11 COMPLIANCE DATE: 10 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ` 7 13.z O �l oxN�� Rv 1-4 ,tHE ✓ �C� � NO. UN Illeg- e s DATE /✓/q� • tiAlZTisrABLE, : MA83 y��BO pslge 99, ~ F ET- 019. Town of nstab REC. BY Board of t 367 Main Street, Hyannis MA 02601 Office: 508-790-6265 Susan G.Rask,R.S. FAX: 508-775-3344 Brian R.Grady,R.S. Ralph A.Murphy,M.D. VARIANCE REQUEST FORM All variance requests must be submitted at least fifteen L J days prior to the scheduled Board of Health meeting. C66 NAME OF APPLICANT IC. )ae, rn�(a � TEL�I�TO/� I � ADDRESS OF APPLICANT / NAME OF OWNER OF PROPERTY G SUBDIVISION NAME 40 DXrE APPROVED ASSESSOR'S MAP AND PARCEL NUMBER LOCATION OF REQUEST 13,2q , SIZE OF LOT 0. aC,--SQ.FT WETLANDS WITHIN 200 F YES VARIANCE FROM REGULATION(List Regulation) REASON FOR VARIANCE (May attach if more space is needed) __rr 1— /O� ilk -a Pry �,s I Soo PLAN - FOUR COPIES OF PLAN MUST BE SUBMITTED CLEARLY OUTI ININ 0?0O0 VARIANCE REQUEST. 10� P"��U VARIANCE APPROVED Susan G. Rask, R.S., Chairman S;Zrs NOT APPROVED Brian R. Grady, R.S. 'S s REASON FOR DISAPPROVAL Ralph A. Murphy, M.D. i SECTION-SEWAGE LOT 440 SENUIMARK . DoNaL._p M. COOMBS HYDRANT 734 eoX 91s Ow r�l� so / EL-EY, 47-'7fo I I -SEPTICTANK- (p I -"D"13OX- g I -LEACH �I� OSTa=Qyll_!_E�MP OZ�SS / TOPdpFpFDN -� - �1Sl3A�µSU• ^S^OFI/eTO H^ / �• . WASHEDSTONE �Y ASS A S Lf.--o LOT 22 O WNER PAI-RIGIA 1 (i 4' L.� G. 5041� IN• O DUT.. IN. 0IT- INS i•:' db'L=4O.S / �,� /!' 40 {(•00 4 p.7D 'TANK 40.45 140 (] ❑❑ TnL- II Z. ELEV ELEV. ELEV. FLE Q O❑o I .. - . �- ,—A:01 , ELEV. ELEV. ❑❑❑ I. ` oa !^ O a 1Nw 4 H WASED STONE ^c -g. ♦�'v`r*r "d'r"x+wi t''.�g,CN!c ,- .1 e '�qIt 1� •a � 7 TESTI HOLE LOG TES # Is96 -rH 2- 'By.T MCLEU-4^" y DArE /0/9%85 *:As� 2 s.;,.::Y"AtGS^P '. .:JI �AGOB( FjO H... .W,ITNE�S'J.CANI.ON' ,,ga'3z p�.•�w`r' .,+z �^•' +� f� ' ,7/ ,4 ra TEST By. - �...,. iigi E: 7 r- ,rr;,b. q..ti `3� .; "' . ,w. 3' - .�,�" o• /. WITNESS. 1� Ll ":r 'Am,- �. s2 a rF- .t. TEST.OR ` �� S' 'DE$IGIV `- r �? BEDROOM HOUSEsa 'ra ,fit. r.F,,l,<, T- 1 r ), . 4C.0 `T.H •2. wa t.. e (_ 7yTi Y.'.<, t1;, F `/ v `/ Cp Q/ O ELEV. EL v.-f-to Su L �I LO M Solt_ w•" .,# tdSPOSERDI>;POSfiR •K.R>. ^ ,/ i/'M� , V .. - •U �� „•' 'Apo E$ INS RATE ' t w s�y;INED 6IM F FLO W RATE oLMAY f ..O SEPTIC TANK MED MEfl REO'DSEPTIC-TAN K'SIZE ( x. �lDrZl �.. 7 AN LEACH.FACILITY t f S SIDE WALL 16 IT4=12b '(3.5^1 - 315 G/D. .BOTTOM. qz-r = 70 - (I.o(. '1S G/D. tC.'` "�. alI i 35 149' 32.0 TOTAL- 20+ SF 39a ' c Wnll , /� ; s �Ei, 4 �/ I USE: I P1�ECl�S-r LACNG �r EHI 1 I0 10' t G DIQI✓1. > 9' EFFi C�EiT"F� WATER ENCOUNTERED f .. � •�.....(.r-fir ��'� :\�` `% - NOTES: (UNLESS OTHERWISE NOTED) ++YA NN 1.DATUM IMSU='TAKEN PROp1 15 pUAD11ANOLt MAP - AM]"V V FiEV. G. ,5 Z.MUNICIPAL WATER AVAILABLE - Of ].PIPE PITCH,U^PER FOOT .. ." t, •..• �{ �- EJl`V .�S: 1.DESIGN LOADING FOR ALL PRECAST UNITS,AASHO• •N �'� ` S.MIN.GROUND COVER OVERALL SEWAGE FACILITIES,(11 FT. •i'}/q. ARNE H. ,.,�IL PIPE JOINTS SHALL BE MADE WATERTIO"T " 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WIT"COMM.OF MASS. ( CIIVIL t q'O ♦ 1 SPKINCr' _ - STATE ENVIRONMENTAL CODE TITLE S - _ ]DLjgy r+mows d T I ... SITE rL`AN B. �.JCY''�@ Ub6D PCY�.7ROT1L+"f LwJF.+�•�4 / 5 •N ��(it 'TK [,q �. y. T�s ARNE ^. �E�.I f2✓IL.t� • RE0. ENGINEER RETAIN INGt;:WALL SEC1tON U �u OJA } a - ., � •` 4' REP: '�, 3".4GG - p�f�OWd't4pC'engipee�ing `,.` 4 PREPARED FOR:I�IckilaEL MoGON I Gam_ " may•E t''I�', e"'• CIVIL ENGINEERS }I C MA !•g1 z M LANDSURVEYORS snO RE4 OR. III �"i`•r3I 2D 1 P 11TE RIB% �5t Is 0 8CONTOURS APPROVED REyISE f .. - No.�s�l.0`f F#3 L4 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH i6..IN...............OF.._BA.'2l�!.S..TA.3.. .........._................................ Applirtttion for Disposal Hindr, Tottstrurtion Permit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: QX.. N ---R.q----G�.f 2vt.LLe......_........................ t..'..................••--•-....._....... �- L«adti ddro, 5...5cui.l.:. .N�.1.1.Y�. C.Y.15_..___.................................. ...... Owner Add—, ....................... ..........................-..............................................------------.-_ Lo ..._.... '. Inrtallcr Addr<u Type of Building 3 Size t........:..... ..........Sq.feet ., Dwelling—No.of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) WOther—Type of Building ............................ No. of persons............................ Showers ( ) —Cafeteria ( ) > W Other fixtures.................................... W Design Flow...........J�5.......................gallons per person peFF day. Total daily Now ........--...........gallons. WSeptic Tank—Liquid capacityLO. ...gallons Length...YY.Y..F.a..Width:.'�..YL...Diameter................Depth....t. >� x Disposal Trench—No.....................Width....................Total Length....................Total leaching area....................sq.f. 3 Seepage Pit No..........)..........Diameter......j(7........ Depth below inlet...............Total leaching area.. x Other Distribution box( ) Dosing tank( .a Percolation Test Result` Performed by..A:J.hME?5.�... �:. T:.M(:_� Ch?N--- Date�/Z'03.... ...�1bj.ss 1-1 Test Pit No. I.........Z...minutes per inch Depth of Test Pit....��.Z:�.....Depth to ground water../f!LlM........ W Test Pit No.2 L......minutes per inch Depth of Test Pit....III:°......Depth to ground water...41411:� x ...................................................................................... O Description of Soil#..�.....6.-.I.?: ...(Q4! .:_S4:QrlMl.:........�L-.3Lt..PIEoSa. .��FIivES...................... v .L. 1.3d"...M.FP... 1! !r�......... _ .._.... .r.3......._(OFLM... 1.is9:'.....(?f7....SF.._D........................................ ' .............. ...r tJ Nature of Repairs or Alterations—Answer when applicable....��.... ec Y.-.._ ^C'............................................ ........................ .............................................................................................................................................................__........... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of:I':LZ S 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.. . ........................................................ .........................._.... ty p p to Application Approved By.._. `.' way.1!r.:,--e�.....Nhrtr�?.✓..�r�—....._.......... ..��1//..ld.�............ Date Application Disapproved for the following reasons:................................................................................................................ .. ...................................................p.....................................................,............................................................................................... Date Permit No....0 sr2 `Q .........................._ Issued Z.t ..!I � ...� . ................... ....D THE COMMONWEALTH OF MASSACHUSETTs BOARD OF HEALTH .................OF �Certifirttte of f�omplittnre THIS IS TO CERTIFY,That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by 1�r-<<... . ............ at.. .. ct.......................:7....., ..... ...........!!.4!....:w............ ........................................................... .............. ................................ * ............ has been installed in accordance with the provisions of TITL% r of The State Sanitary Cede as described in the application for Disposal Works Construction Permit No.. -..7.1�-/.._............... dated_...L.c2..jll..�`�.S ................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...........i..ci......:.... ...........:..,.>.............................._ Inspector.... 1�Et1 Y.�.....1..=� � ...................... ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF.....L-'., .................................... .............................. No.:.....::.....�'::+.... Fee. ........:"........... Moposttl Worko (IIonstrurtion Permit Permissionis hereby granted.../.'!c. :.!:.............................................................................................................................. to Construct ( ) or Repair ( ) an .Individual Sewage Disposal System at No .......... Strcee as shown on the application for Disposal Works Construction Permit No_ 3: :4-Dated....f...'�i!. ............... DATE..............................................................................- r w. 1 No...V,1j. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........-I ._.A N...............OF....QA%5..T.G ---------------- .:._.....:: Nki iratiou for R-4pa,itti Works Tono#rur#ion Wrmit - Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual' Sewage Disposal System at G4 . ..... N.- ---- ------------------........... .....:lo ........................................................ --- - ___ _..... ... ........._ ...• Location Address 4 r Lot No. ........................ ................ cc�....:- W----....l�t.Y..!4 �v 1: .............-- - ----•-- Owner Address aR --•.......................•-•-•-•-...........................:.. .......-•-••-......•................_.... ................................... ......• . . Installer Address, U Type of Building Size Lot.... :3?..........Sq. feet ., Dwelling—No. of Bedrooms.................. .....................Expansion Attic (' ) Garbage Grinder ( ) 4 Other—Type e of Building ........_._ No. of persons...................... Showers yP g ..-•---•--••----- P -••-- ( ) — Cafeteria ( ) ,. Pr Other fixtures .................................. Design Flow...........-ar5..............!........gallons per person er.day. Total daily flow.....3.3.6...........................gallons. Septic Tank—Liquid capacityiO ..gallons Length.-_&Yam.. Width..I. .yip... Diameter................ Depth.. ...%. x Disposal Trench—No...............:...... Width.....I.............. Total Length..........,.._..... Total leaching area....................sq. ft. 3 Seepage Pit No..........I.......... Diameter...... 0........ Depth below inlet...............Total leaching area....... ......sq�.�`oj Z Other Distribution box ( ) Dosing tank (. ) ''' Percolation Test Results Performed by...A�%;-s 6JQ -J...�.�....r:.n'.CL�.�h?. Date5/Z,3/1Ba.f...I0/2JBS a Test Pit No. l..•...LZ....mmutes per inch' Depth of Test Depth to ground water..NA1 ....... Test Pit No. 2......._2-.....minutes per inch Depth of Test Pit.... ....... Depth to ground water..A8I�E....... P4 . .................. ------------•--•--•--•..._...................: ...---..........----......... -------.... ......... .-------- O Description of Soil .I.....&n.I .'...�-�?!4.(!'.z.__ Sld021 - Z-3 "-_n'E 7 SAn,.j (w FOIv� ................•---------- x �. ....1.3z• ...► . ._s�....r� ..... - �' !9M.. 5 3S �L .......3...--�-G.... '?6P.-��h!.?...�q.' w6 14 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:ITLZ 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.. ••----------•-----•.......----•....................... . ................................ Date Application Approved By.... - _... ---•--.... ...--••-- ��A/_i.?................ Date Application Disapproved for the following reasons:................................................................................................................. .................... ....•--- :...._..........---•--.............--............-•-•------.....-•---•------•--•------•---........................................ .. . ...._......... Date *. Permit No....4.6..1._Aq............................ Issued......I.A 4 l Date �� J No..��........-----..... FEi..-.........L............ _ �v r THE COMMONWEALTH OF MASSACHUSETTS - BOARD OF HEALTH ...............OF.... -- . ........--------........------..... Appltrtttiun for Mipuuttl Workii Tongtrudiutt Permit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: tT 21 N l CC � G'►rtf--• ------...---•••.............. V....!..l..L� ......------•---••.._.._.... ..........•-•......_.......-•-•---- ._ Location-Address ?4 . Ar Lt No. . — ...i•—00LKLE.--......_ r c, � ------ Owner Address WrC...................••-•.......••---:....--•...••-•-••••......_.................... ----•--•---•......----•----------......... Installer Address Type of Building Size Lot....D:.3 ..........Sq. feet Dwelling—No. of Bedrooms....... ................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............. No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures -------------------•...........• . . • . WW Design Flow.......... .............gallons per person per day. Total daily flow......133.6...........................gallons. WSeptic Tank—Liquid capacity.« ..gallons Length... YZc.. Width.. .YL... Diameter................ Depth..t'........ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..........�..._.-__-- Diameter.......I&._..... Depth below inlet....'.`.�:�.........:Total leaching area....�..3......sq/ft6/6 Z Other Distribution box ( ) Dosing tank `" Performed J I ( pPercolation Test Results 1 ... :.- fA-5 Date-5,;.....�—,..73.................r ... a a minutes per inch Depth of Test Pit. L' Depth ground Test Pit No. 1......._.7:... D th to water �O ._. Lt. Test Pit No. 2....-- -......minutes per inch Depth of Test Pit....Zf.t........ Depth to ground water. A Q0'....... phi - ----------•-- -- ---.....•••......... ........ ....... ..._....------ O Description of Soil�...--!S!•-•1 Z" (DAtrt Sty 51�1 ...... 1 Z'-3 -11 �yl�o S t j Gvf F/Ie�ES........................ ..........................b -. �i... �4! .. 'SU56tC ....... ' .-. i"_/}7 _Sprv ••!��/Fl,v "�' . Uy r`t -- -.----•-•--•--------- ---------t U Nature of Repairs or Alterations—Answer when applicable.... -� ......�....... !!' ........................................... .....................•-•----.._......-----••----•-•----------•-•---•--------.....-•----•---•----...............---------------•------•-----•---•-------•-----•---------------------••--•-••••••-•-•----- Agreement: The. undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with 4 the provisions of AITLZ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation mitil a Certificate of Compliance has been issued by the board of health. Signed_ -----------•----•--....---•----..._...-••••--•--•----......... ....... ........... Date Application Approved By..... __.... .��"�-.. l�l�f._/�S'................. Date Application Disapproved for the following reasons:...............................................................................................................-. .....:......... ... ........:.. ...................: te Permit No....:& .-•-----•••-....--••.. .... Issued.._.. - Y a .a�.. d 4. .. ......... Date ...........................................___m.__....._<.. .__ ......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..1/... .......OF...�. . ... .. I .. ................................... Grtif irtttr ,af fauutplitturr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by....Za:` .......................................................---...............•...--•--.............--------...........----•-......----•--•----•--...................................... / !l`` n Installer at.!.:..t ?(. Fo -' �T rl-•�.�5 f_..f R Gt /,� ..._. ...... ................. .............................................................................................. has been installed in accordance with the provisions of TITLE r of The State Sanitary Code as d scribed in the application for Disposal Works Construction Permit No._?�'74//................ dated----- .�.; �1.,.. .............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. r DATE......... --....---I•-i -------------------------• ...... Inspector....... � a % �/� .. .........,. ., r<.... , � _ �_ _. y _. a.. ......._._. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH t 3 NO...............(....... FEE ................... Oiupnstt1 Vorko Qlunutrurtilatt lirrmit Permission is hereby granted... ................................ _ to Construct ( ) or Repair ( �)�an Individual Sewage Disposal System at No. �r:'l .�5-�t fly v _� .................... ....... ......................C.:......._......1.... ...."___............_._.....•.........._._............................................. Street / as shown on the application for Disposal Works Construction Permit No..c�� '_ .. Dated.._.` ? !..1..................... Board of Health DATE............ .................................... ;. 0 C ION j SEWAGE PERMIT NO. VILLAGE IN �,IA LLER'S NAME & ADDRESS s � B U I L D E R OR OWNER DATE PERMIT +ISSUED � 5 DATE C4.O,M PLIAWCE ISSUED i i I f® 0 e1 rlab a SECTION — SEWAGE LoT 4 SEN NlARlC LxDNa.L.D H• cooMi35 HYDRANT -784 150X B I S D L-r-> M I L_L- RS D l El_E�, 47, 7G I I -SEPTIC TANK - �j -"D"BOX - 41 -LEACH f ITS oST�2�I1L_t_E�MA . OZ.C. TOPdQ��F22FD��N��yy (MSL)a "2"OF IISTO V2" WASHED STONE h , 5 R :S MAC' i_ c� � ' 'ATRl�131 A pi N4L fF + ____ „i: G�I ��e�`�r'�I�tt: 'ria ► `31 G 5 f�g-!�a OUT• IN• OUT• IN• =SE -- �740 D 40.45 40 ❑ ❑ ❑ r" m1�'r1ELEV. ELEV. ELEV. ELEV, ,a u ❑ ❑ I 11 0,33 40.1� 11❑110 s �" ELEV. ELEV. .++�'" . WASHED STONE TEST HOLE LOG YE 1sg6 _r H a BY T P�CLeu DATE; Io/U/S5 TEST BY -ArGc�f f3a°I� W ITAJ�S-J,car'i LoN . a s WITNESS. TEST DATE ar7 Z DESIGN BEDROOM HOUSE (17 p j D I T.H. r 1 4-�.0 T.H. 2 E .,�y .1R ELEV. L I,0 �N. '' LOAt Sv i L_ 3' t 6 ELEV M 6:o9 L L DISPOSER DISPOSER . nNO �`1, PERC RATE Z MIN/IN._ " MED ANo. W FII,,c- rN 5 h w FINES \ J; \_ �`• 36 3 �FLOW RATE (GAL�DAv) -' o O EPTI TANK 1. _ S REO'D;SEPT C TANK-SIZE �l p AN �N LEACH.FACILITY }y SIDE WALL 1.6 n4' IZf� (_ ) e '315G/D. f /l BOTTOM 5 = '78 r o /D. RWET 144 32,n L� 2 .5r- I ) _ �8 G 6/ A TOTAL- o� 3q - f` e�~0)tv USE: I LEACHING SIT' / 15 / (I + WATER ENCOUNTERED Q?) NOS (UNLESS OTHERWISE NOTED) LET _r t -75 1.DATUM(MSL)TE :'TAKEN FRO ` QUADRANGLE MAP '��wVr F �� - - 2.MUNICIPAL WATER AVAILABLE 3.PIPE PITCH:k%-PER FOOT l 4.DESIGN LOADING FOR ALL PRE CAST UNITS:AASHO- -44 -/c... ELEV. - SV S.MIN.GROUND COVER OVERALL SEWAGE FACILITIES:(2)FT. ARNE H. r 4 F 6.PIPE JOINTS SHALL BE MADE WATERTIGHT �r OJALA _ 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. '" CIVIL y 4.0 e' !� RF—LAR -Z SP/ INCr STATE ENVIRONMENTAL CODE TITLE S N . 30792 1/ ° SITE , PLAN `N :r a-a P�� Oi y�1gc LOCUS: t-�o c- �E Us�b �a� 7Cz��ZT`C �uG ��-1►.�n._►V . 2 t AR NE .o G- F"Iel"F F=Q yam, REG. RO ENGINEER- � RFrAIN IrgC-i V SAL.L.SECTION H. to 1 1 caOJALA r2c r� REF: "��ln �. - d®WJ7 elope eft, ANe0Pl,*7.v PREPARED FOR: ( �i 4a {•�9��•Qr J I CIVIL ENGINEERS .... LAND SURVEYORS --3` BOARD OF HEALTH —REG.LAN URVEYOR (EXISTING)---'-- ....._, - Tn'aLE-MA ®'� �1i1�. CONTOURS L ` , APPROVED DATE $R�TJy -1/IS ES) o-IO-'SS REyIISSEO g��;� 7, �D DATE (PROPOSED)-O-O--O'®�� --�-