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HomeMy WebLinkAbout0027 BELDAN LANE - Health Z.` �Pldan Lone 031-- 0o-z S M E A D KEEPING YOU ORGANIZED No. 12534 2-153LOR FORTAEs W MIN.RECYCLED INITIATIVE CONTEM 10°k CerpfiedFi6erSoureinp POST'CONSUMER® wwwsfiprop°ematp Sfl0119p MADE W USA M ORCAIWZEO AT SMEAD COY LO CATION SEWAGE PERMIT NO. JJ VILLAGE INSTA LLER''S� NAME i ADDRESS C-) R/N 3UILDER OR OWNER e4j.. DATE PERMIT ISSUED :A0 DATE COMPLIANCE ISSUED r 5� � �� ._ � � � �o S� � - w .. ��� � .. ;. No.. F�s...3 d..:.'�... ..... THE COMMONWEALTH OF MASSACHUSETTS �� BOARD F H EEA H lC�G✓'��_ OF.... �X/-J.1.1 t).��................................. ApplirFation for Uiipoii al Workii Towitrurtiuu Prrutit Application is hereby made for a Permit to Construct �(k-) or Repair ( ) ,an Individual Sewage Disposal System at: Locatio Address � or . .CC'�,.!/jldl. ^ 1 :... ... !� ---•---••-•------- --.�J-_�k.--.520....C�� �1�. .......................... Owner �• Address per- s . ? -------------------------------------------------------------- Installer Address UType of Building Size Lot---- feet Dwelling—No. of Bedrooms._........�--------------•__-__.-__-.Expansion Attic �CT) Garbage Grinder (iV� Other—Type of Building ............................ No. of persons............................ Showers (/ ) — Cafeteria ( ) P4 Other fixtures ......................•-----••-. . W Design Flow.....33_r-.............................gallons per person Ver day. Total daily flow............................................gallons. WSeptic Tank=Liquid capacityA.0.90...gallons Length____•---___•-_- Width..V--__-___- Diameter________________ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter............. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tan ) aPercolation Test Results Performed by..____ -` __( ._._. ^.�Lh' ��1._ ._...___. Date__._ , _ d._.__.__._.. a Test Pit No. la _� .__mmutes per inch Depth of Test Prt----------------_... Depth to ground Gz, Test Pit No. per inch Depth of Test Pit.................... Depth to ground water........................ -••••--•••••------------ --•-••........ -••--•...... •---•••--•------•-........-•---••---------•---------------•--•--•- . ................ Description of Soil a LuAn? k S f� - - _..(::1f f �-----... U --' � ✓1 ---------•---------•--- ----- ------------------ -------------------------------------------------------------------------------------- ---------------------------- ------------------•-----•---------------- V Nature of Repairs o. Alterations—Answer when applicable.................. ..__._.._.._._._....__._.._..._.._.._.__.___.____. --------•------•-......•••-•---••-•••••-•••-•-•--•••--••-••.---•-••••••-•••-••-••--•..................•-•-•-...........--•--....-•---•-••-••••••....--•---------------•------••••-•--...........•-•.•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i I TI.," y g g p y of the State Sanitary Code— The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has been ' sued by the oar of health. /p Sig ed... -•-�'//-•.•u•--•--- Date Application Approved By......--- ----�..- ......--------- Date Application Disapproved for the following reasons:------------•---....----•---------------•-----•--------•------.......-..-•----------------..................... -•••--••-•••-•--•-••---•---...•-•-•---•••-•-•-•••---•-••••----•--••••-•--••------•-••-----•--•-•••-••-••....-•••-••••-••-••••----••••----•••••---•-•-•---•......-•-•-•••-------------•--••••-••••-••----- -. t ?—If ^ ate `•� Permit No. :... Issued........----•-••-•-•-•-- ---•----- `� Date it S.f . ...... Fes$..,3 d ...... No............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliratiou for M-411nsa1 Workii Tunitrurtion Frrutit Application is hereby made for a Permit to Construct (,*-) or Repair ( ) an Individual Sewage Disposal System at- ------ Locatiorn Address ��++'''' or Lot-No. ,f,2P�.i: t •�/1 ''; !Jw!J� �/C% C��+".,�r"l t.•��� ....................... Owner Address Instal Ier Address �� ���/ d Type of Building ..�- Size Lot__ ;..................Sq. feet U Dwelling—No. of Bedrooms.......... ..........................Expansion Attic (XT) Garbage Grinder (A.',e)7' Other—T e of Building No. of persons............................ Showers / — Cafeteria a Other fixtures .----•--•--•---•--•-----•------•-- W Design Flow......1 ..._..•....................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'capacity%oq---gallons Length____-�....... Width..../_....... Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No----_-------------_ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. tank Other Distribution box ( ) Dosing (( ) 4 /�/ c�L G.� ----- a Percolation Test Results r�s'n Performed by_________ ___ ______ `.._._..._._. -.._--_-_--- .- ------- Date.... .. .. 1.4 Test Pit 0-4 No. 1.. .... �..mmutes per inch Depth of Test Pit.................... Depth to ground water../'t!6�rr� l r Test Pit No. 2X_ot __minutes per inch Depth of Test Pit.................... Depth to ground water........................ = .....mod/° (..... O Description of Soil-------C�------------------------------------------------------------------------------------------- ='�f,,:�l�,+----=-------�----------�----------- -� - ----------------�-�---- :... 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 TT y g g P Y 5 of the State Sanitary Code—The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has been issued by the,. oard%of health. ` I--•-•---------------- e Q- -----• .. Sgd.....t! . " .� ; Dat Application Approved BY t4M- -- ----�----------- Date Application Disapproved for the following reasons:..................................................... -----•--------------•----------------•- -------------- .....---••-----------------------•-----........-----------------------......•..---------•-------------•••.---•-•••----•--------•-•----••---•--•-••-•-•-•-•-------•-•••-••-----•------...._......--•-••-- Date Permit No.. - -.... Issued---------------•----------------•---•••.....-----•••-•- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OFF HEALTH WA , :...............................OF. q............ ,�/��J�./1� Tntif irFatr of ToaaapliFaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (-'I) or Repaired ( ) - --•.................... Inst ller has been installed in accordance with the provisions of T j o The State Sanitary C de as descril7ed in the application for Disposal Works Construction Permit No. ..___:_ lr- .----••-•--• dated . THE ISSUANCE OF THIS CERTIFICATE SHALL NOT,BE CONSTRUE® AS A GUARANTEE THAT TIME SYSTEM WAL FUNCTION SATISFACTORY. DATE._..._._ .f `" --•---- ------------ -C-� ------.......................... Inspector........ THE COMMONWEALTH OF MASSACHUSETTS ✓f' ...... BOARD �OF HEALTH �J ....... /�Gv/�..... OF....... I .............................. /f No......................... FEE__ `'_-............ �i��rosaal o��� oaao#� ion rraati� Permission is hereby granted......-t�--�7i./-t'-r-,------------<. / �------------------------------------------------------ to Construct '(e) or Repair ( ) an I dividtial Sewage Disposal System at No..........................................l' �`id/�f'.d�� Street / as shown on the application for Disposal Works Construction Pe t No. �_.__ Dated._.L?:'-" ...... .w _ _. -------------------•-----•-- DATE------ . ------------•----'.......................................... Board of Healt FORM 1255 HOBBS & WARREN. INC., PUBLISHERS .,. •t 4,-; bt � - n 6 , n art ,r t iy4+an�' 3a ri � jn a 4g:'�r7 r1Fhy� 7iM. �ai)tif� �Pky'�y,lpf% bY11. Mt'. �� +s +,s..t, 3• s t. P .. f ° : Y I '4"Z'� TklrR. l c +,t'' x ".� ,a i t y,:. 4 s•x y mo„ i �1 a 0 rKln ju s , !,";,� r 99 M" a r �0. ,��' r, '�• ." rJ'`a - 7-'-� R t 1� � irc � � 11,��•-N fir} Y, ht !a y ws r fa�5 S kdr �ja 't a •�cT s• n F q l `,i' �f ri - y J� r; �, +. +1rcfiti Y •,: "': °' xr r Cybp, k 1 ryr 47 s i . iy�� II 4c.� i, Viet t•s 3 �",�f„ �$5 }rN �tj.� fir n t fl � x� r § th'' '�; � � TR�C •N ^`0 �22�: \ [ o"t 'agr�rc�'r i "�l�F�. P5 �,� xz, Rom, }' x,v�°�^` ���� - q, VV 6 ,•,� g r� �, c: PI /..T i/ --. � 1 i x� oaf as {tu^ �4�. � � J:� .+xy}�,,�» k 'y.• � \ l ' k'r s.�'1 i ,r.i+h�.t/C j to OBE ' P UNIKIS #°ta r n, J "kx b3 •. ` {.. �O � t �© Y et A' d Off. GISTli ON Li i w x 'N .' ..reyTty,F,s , `LEGEND EXISTING '; SPOT ELEVATION Ox0 CERTIFIED PL'pT' PL4 ""i EXISTING CONTOUR — - - 0 QT Z FINISHED SPOT ELEVATION L FI�►iSWt=U CONTOUR -- 0 G' IV.T,�2�//L.L� 1 ` APPROVED BOARD,.*, . OF.. HEALTH • f 5 ky( � ♦l�r} r kY._i r • $ Y {., , _ J.JI AS e,■ A S L�,� DATE. { ' AGENT SCALE =.�D a.DATE L DREDGE .ENGINEERING cR���reR�� CLIENT ......_:_ .... ! CERTIFY. . THAT," THE, PROPOSE ' p y{ .. !F R S{"1 NtI GIST'Eott f REGISTERED j JOB NO. 6.9 ILflING SHOWN ON THI$ PLAIN .+ , x f CIVIL LAND CQjNFORMiS ..TO THE ZONING K �. ENGIN EER4 I.. SURVEYORS�I DR. A.. fl f} :_�I OF BARNS �E , ANC. MAIN S+ 712 MAIN T CH. BY � S0: 'YARMOUTH, MASS. NYANNISF MA".; YDA�ZSHEET_._ OF TE ',' REG. LAND .S �r � x .._��.. _P.,i �__� � .-.-: �,. :: �., __•�� < - 3 . 'tics::.. h- - 5 �`"� �i!.a "_-Y+.'Lk-'.-.:�- yi"'41.1 �.�. �,-. .:C't'�, -q r..t- :- - ..„�. -. ._ -A •i.? -- , :r-} w �..s _ '.; + n -.0 ;c±-4 _.:ff ,•b�'a+z._ =?c'�- .c ;, `� - 1-5 ;�:�' � - ..g:-�: ,. i' ter. .S^:-.:'K.' Y'.�'i.'b=,r v.. l� 1 •? .`fie. ..��. `YT�-W G �v1•�:... �. .2T.' Y-;•a" �s 9P?z: ...�5 J+..�� 1} _.-`_ _ 777, .-i�-:•r f. 4-ar3fi,.._ ,`'� �:, .,.v r,...:.15 ?'`�'..__...r ._.�,. �•.. �....I-��/Y.. _.ram -'.,_ '+3:"4. p >;,:->--" , �- <..„._:,,. .�-r.,.r�•"5... _ ,,. ,�.;�'�!� -. emu' - - ':CF!/ .t, R�-�-�'Y7[i�1�`f �G G`►4s ''?- as-.,:-� �' <.:� �� '-.':� _ . .a R__., ar:'�_� .. w� r,' � :•:�� S},rAL l �P� -'-3'i - 'k`�" r Ida �., ,� '�' ''�[,y�4 �>"� '��.-�• �:�- i� - .K-r �'.� r = /Q/-1/Ey1/AY WIN. TCN . /N l> a !3E FISE •: z wA 8R I /V CRL�TE f 2'o M/N: �CD c ; µ *RAOE CU VER CL EA/V 'SANG, O:I 1 I � _ `_ •; _ '. -2 LAYER CYAL ' v G l • /I • • e • • • v °p° o� MIN. P/T -TANK CN SER_ p/ST. • e • • s 1 / "• n , I W ENE 7'1C �i BOX • • m S I'. 7 � o s Q;. s v + 1 r rEFFECT/VE 1 . • 3l4 — 12 v . : tpac11 • • • • o�Dl yEDSTO/YE s WA 5 Is o 0 0 PRECAST SEEP.gGE cama l • I� o ' o • • • • • P, a. P17 OR /N{�ERT AT BU/LD/NG S S FT -- -- -----�j INLET"SEP7"/C TANKFTaiFT. U/X1l►'1_ C EE T<IB UL A T ION S r` Y OU;a'LET SEPTIC TANK . _FT. INLET DI57R/t31/TION BOX FT. SEs;T/ON aF C'ROVNV AT ER TABLE 0UTLETD157R/BUT10N BOX S3. FT 5� .4GE /S/�OSA L .SYSTEM /NL6T LEACH/NG F'/T �'3, o Fr. TABULA'TlON LEACfi INC7 101T 01MEN5/0N A _�_FT.' D,ES/GN C/4 TER/R SC A L E %4 ' _ ./•— „ NUMBER OF BEDROOMS _- � � DIMENSION C �—FT. GAR-CAGED/SPOSAL UNIT__. f SD�L LOG L TEST TOTAL E.ST/N/ATE•p FLOW_�_3% GAL.�DAy' SOIL TEST /4&1 SOIL TEST*2 NUMBER OF E4CN/NG: ,u/Tj !^ELEK,�s'S� ' �"ELEY,__ PATE OF SOIL TESTZ�' • S/OE.LEAGH/NG Pt�K P/T _/_t�.�_SQ. FT. e� p ► Z I / RESULTS d�/ITNESSED BY 1_--�'h/ �1 -- 6UTTUM LEACHING PEK NIT 77 ,9S4• FT �c �S«{s ` PEMCOLAT/ON RATE IpE/.' /Q ` f TOTAL LEACH/NG AREA ���S 1. FT. / / pEfeCOLATION RATE 9-2 �= mj v.//NCH RESERVELE.4CHIIVG.4REA��SQ. FT. — �G�.f• S� SG.. - ... Goa�a A.2--- _ a r, s �� _ t `f Y Cy 'fi ik /�L/®� f` '� •• - , "b. N� 7SJ.rx 9 (/�� yr�1 q` /w�/'�- ./may/♦ A sq / , L'r 1—D� ♦ED Cy �I.Y�I�/ �I-',Vc VOp J�vc 7/ /HA I N 5 - �'"r_i 33 NO /YjA/N ST.. :c .3 .k ,fir .� ,;F .l -� ��• �. -s• } x.- MA T SS :^ Yf1 RM(lIJTK A9A Vl4 YeR ZrAICO UIV 7, ` "4..;,.f *:b a {. '6g4"�a..r„�y S,y.:y.: �. 's:' t+• `' , _ CeR 0 ATE $N T Yr � � _ JOB E.E ND y a,;� n x kC r x'� � � �� a'•' (. .. � .. ! � 1 .. I . t li ; qq��i G$��i� �c� "'�y_g�i ,±5'J� w .ba Yy.a�'_.> � i.. •. � � r "?rP,gt hq���� utKs`�is tt yf'v .t t r r ,-a• - - Fa t} \ 4r3° 'S d. rj`rlrf�,��''i' .`s ;i�Pa r 1 F �t,k 5r k• ypr 1°{.. 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',.. � � .:,�- J ..,�� � k 1.Yr s� �r� r �}�f�v�� �..P' ��r41�yk �S'`i. k�x✓ 'L,+,."4t''� �`a.'Fy G 3 �-�j a! r - i ' Y 1.,. 1 t �f k -y A k TZ Yr ' t1" �a t( s:'E,i J d r `6 q t '� -yip• �. 'U' i� Bu►TKiSr.2. 0.Z2162 , fQ ti x r' r c.. - •' A, �, `' _ �J s , FS, r/ -M- ', ' � • � / ` ONAI H �--/v �'� } X n i•Y i{R "xis h r '" . "',6 3 O Q �/� � D "W. , � x Z �g } 6_= yfi4P.: �°at•��s t n} is - � - _. r r� +r' r �; t �,. �5 a 3�'�y�r v F 1ti Say }fFE��r�5�'�.a� . q:. r� LEGEND �# EXI'ST:ING SPOT ELEVATION 0x0 CERTIFIED , PLpT j PL� N �N° XI:STiNG'`'CONTOUR - - - p F.iNISHED -SPOT ELEVATION 0 0� _ _ G—D FINISHED ,CONTOUREa 0 -`-- - - C'�!�lT 2✓// i l�.t f "'��` y t 35 r•s�s y�n.'.h L. -r:, ^..¢- . E _ -. - - .�} �"� Cp �> 't W�` � `"1 s s . N ; APPROVED = BOARD OF HEALTH �� 9 A1i �•i �/+M AGENT ,� Cl Y - -- - SCAt E /' - �" DATE c EDGE EAIGINEEkkG' CO­ING''k C L 1 t� 1A T „ ,. . REGlSTEREf7 " 7. I CERY F.Y`�� THAT THE PFROP�S h EGISTERE �� 69.. BUIIDING� j J98, NO, _ SHOWN A ON' THI$ 'PL.,. ` CIVIL • LAND FORM ' T s CON S TO.. . HE ZONING t .A EPIGIPIEERS,{ L gURVEYORS� DR. BY _ �OF BARNSt 8 E ; --- x� dr + ,2 l fp.•/� Z W 33 �'!YC MAIN ST 712 MAIN ^T CH. 8Y _' �r 4 <> SO `fI1RM0UTN, MASS. NYANNIS, MASS � i . . SHEET ` OF --- DATE' . REG LAPi to cje .: .. .�.,., -p:.. .. :a,-'yam,. .r _ •�... � -'� rf.' -'•€r dS•.._k::--"2 -:+er :ae S'.-' =: `.. "iCt, h'''9•.+.i �'-`.3�- ,?.� p,� d _ _ _ Try. -•.a;,tyx. 'v-,_.a .. N .e '• �S *H 1-.... ._ - _ '...-. x., 'F .,...b .,..<; r >- r r: µ.:.: +•¢ - :.:ai^ ` �_ F 'Y�7.::..�-..ar.; b�. s,.: ? - e} _.., x'-. `.K y. ,.ors. ,.,.,.k.. ..F;.x;ie -' �g. 3. r4., zz:.:. 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