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HomeMy WebLinkAbout0009 CARLETON LANE - Health (3) co,ri %f, �an� <0 n 6rv,f I e SMEAD No.2.153LY UPC 12934 smead.com • Made In USA �J SUSTAINABLE FORESTRY INITIATIVE Certified Fiber Sourcing wwwifigrogram.org it II I I LOCATION : SEWOCIE PERMIT MO. VILLAGE INSTALLERS UWE t .ADDRESS BUILDER 5 Q / MF- ADDRESS DATE PERNAVT ISSUED D D.TE COtuIPLI &&,.ACE ISSUED : o bK,P 04 �• 2 C`'' �,�Z FO No. . ......... Finz.... d� . THE COMMONWEALTH OF MASSACHUSETTS OARD OF HEALTH 7/' _....._....-- ..OF.............. ✓l•�✓P.=... .................------ Apphration -for Uhip iat Workii Tomitrurtiou Vrrntit Application is hereby-made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ------------------------------ ocation-A - or Lot W Owner Address ------------------------------------------- Installe Address UType of Building Size Lot___________________________Sq. feet �-, Dwelling—No. of Bedrooms._-_ ----------------------------------Expansion Attic ( ) Garbage Grinder KU) pa, Other—Type of Building ---------------------------- No. of persons..r______.__._.:_._...... ShowersCafeteria ( ) Q' Other fixtu es ._ ---- ----- --- W Design Flow.S ._ .l!Y .. ------------------------------------------- per person per day. Total daily flow.................23� ---__-.-..----.gallons. WSeptic Tank f L uid capacity_/_6bV_gallons Length---------------- Width................ Diameter-----_--.----_ Depth.--.._._-.----- x Disposal Trench—No..................... Width...._......_`.�_.__ Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No.......I............ Diameter. 60"t JI"Depth below}nlety�.____ r-- -Total leachi ig area-.-_-.__-._-..---sq. tt. Z Other Distribution box ( ) Dosing tank ( ) ;/14 ' - Y.o 2 "' 74 aPercolation Test Results Performed .by--•-•-- ------------------------------•------------•----•--------•-•----- Date---------------------------------------- Test Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water-..--------.--..-.-_-- (S, Test Pit No. 2----------------minutes per inch Depth of Test P't-------------------- Depth to ground water......ei___.-_----. a ---------------- O — .� x Description of Soil-------- -- �...'.L�! �t .C.1� .. -��--v�`l %%s ��G --------------•----------------------------------...:. -----------•-----------------•------------•------------------•-•-----••-------•--------------------•---•---•-•-------•-------------.........-----......_....••------._...---------------•........_------ V Nature 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 Article XI of the State Sanitary Code—The undersigned urther agrees not to place the system in operation until a Certificate of Compliance has been issu oard of hea ined..-- ------------..................... ....-... Date Application Approved By--------------- Date Application Disapproved for the following reasons:..._.. ---------------------------------------•-•-•--••-------------------------- -- --------------------------------------..-•--•----•---•-.....-------------•- -------------- Date PermitNo......................................................... Issued........................................................ Date No. ' Ficu THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH 'f Appliration -for Biipoottl Workii Tomitrortiott Vrroiit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ,.......................................r ,gyp - �c�. 40c, ocation-Addr z or Lot No? W Owner Address e 1� .0 ... Installer Address Q Type of Building Size Lot............................Sq. feet 0 Dwelling—No. of Bedrooms..... Attic ( ) Garbage Grinder (TN Other—Type of Building ---•...............••-•----• No. of persons--_ -------------------- Showers ( ) — Cafeteria ( ) dOther fixtures ------------2...............................-•---•----------------•-----•-•-----------.......---._........... ._.---- -------------•-•--------. w Design glow_.4r1� :. _t-._•__gallons per person per day. Total daily flow-------------------- _ gallons. WSeptic Tank- Liquid capacity-�!_h-,-gallons Length________________ Width................ Diameter--------- Depth.-..-.--__--- x Disposal Trench—No. -------------------- Width-------------------- Total Length-------------------- Total leaching.area-------------.......sq. ft. Seepage Pit No--------I........... Diameter...!A.�!_S_fDepth below inlet__ _____________ Total leachit _.__.g area------- ft. % ice `/- .2•4, Z Other Distribution box ( ) Dosing tank ( ) dj" � - -74 aPercolation Test Results Performed bY------------------------------------------------------------------------- Date---------------------------------------- Test Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ rXq Test Pit No. 2................minutes per inch Depth of Test /P��/+'''')t-._-__.__-`_/_____-_. De th to ground water...--. .--._--.--_----- w .....................rj. --' - r.. -=J --• •! -------y - fi---�.........-`----- - O Description of Soil O._.:. /° ------------ /�� - ------------------_---- t V ------------•-•-------------------------•----------------------••---•-------------•--•-•------•---F Y_ ---.---------------------------------------------------------------------------.--------------- W U Nature 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 Article XI of the State Sanitary Code—The undersigned f rther agrees not to place the system in operation until a Certificate of Compliance has been issue yy-.th oard of healt ed----- . Date APPlication Approved BY----- ...... - ' - . > .4 .. -•-`----•---- ••.�--:. -..7. ._..... -- Date .... Application Disapproved for the following reasons___________________________________ _ .............•-------------------•------------------...---•-----••-••-••---------••_.... e Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH ............ ............................OF....... ... .... ............. . . . ..... .....'....................... (9rrtifiratr of fu'omplitttta THIS I O,CERTIFY, Tha the Individual Sewage Disposal System constructed ( ) or Repaired ( ) bY--------_--- --/kl----- .... ------ ----------------- Installer at /.�..-.. � '-•----•--------------------------•---- has been installed in accordance with the provisions of Arti Q of Th Mate Sanitary Code as described the �� ' application for Disposal Works Construction Permit No_______ ___________2- ___________ dated___'_____ _-'t�___..� ..._.... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WII L FUNCTION SATISFACTORY. DATE--------- f -_7...... ........................ Inspector. ---- - --- -- - - •------------•------------ THE COMMONWEALTH OF MASSAC SETTS BOARD O HEALTH.�•- e ....OF........ - a�1./ ............. 0 No..............•- F-- FEE._/----------------- Dispooal Workii C11mitrurtiott Vrrmit . Permiss' n is hereby granted - ------•---- to Cons or Rep//�� ( ) n ndividu ewa Ispos System atNo. �- ... ...��'I; ��.. • ... ...... - - -- - ---- ----------------•-------------------------------------------- Street as shown on the application for Disposal Works Construction " -- .. ------- -- . __ ....._�.. _ Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS t SOIL LOG �XV�1�U�Va\V„y-rJK tom/isvtt„jL���yiA.�„x IDl.7�l! 2 _�_o_ �a,l / w D ,��.PEASTONE �- LOAM 9 FILL" 12��MAX, f T� ;,I f 09 0 of Mc�rt1� BOX SpNIS 5'MIN.- 1000 —1° 2:"MIN. ° 0 _ °GAL. a �, 1000— GAL. , a� SEPTIC Io6 PRECAST OR v oc wlTFd °I t 1° °e °°° BLOCK ° c I SmALL TANK Ib°, ° o SEEPAGE PIT 0' 0 S/ ° ° s s ° SroA) p C p 20' MINIMUM o ° '. 00 0� 136� LA YSr2S FOUNDATION 0 o U i 2' , .°�� I %z'a WASHED "STONE SCALEThe i ELEVATION ~ - SKETCH r` 10 —"I PERC, gam'; �Pss_ �2` SCALE: I"= 4' TEST BY : LE-_,A 1011.111c R_LT Pc.° TOWN INSPECTOR: J Mvre BACKHOE OPERATOR : I r SSt�F-- TEST MADE ON-:___�I 'LG G i i 1 I ,1 r i i r 7- e f 1' r�B•9ro q ! Y, < CA2L TON 2AA/C 0 40'wr e P.AvG0 pnvn�t 10,"_E-- 9 EB 9� Z 6 I I O1, r000 GA PrT ►7 t m , Pe*c 6- � 1 a, O 1 J006 GAL ` 4 \ � n � Fu•rU�l SEPT1 c 3g�� {{ u N I�' ExPAu3't6b; TANK f I �+ too 0&AFL a le p64 It 103 t /40./S CB CAP $ `B G3.7LIU — ,sG3—oG — low �s.y.lU -° `� /1!®�r/�v>z sh?Kb� v �1 ,�© r �Q``'�✓t? � wP11t ,�@$ pn S�S�7Co �o Si IC Bv��Cfn>f , APPROVED BY BOARD OF HEALTH ' DATE �`'��✓ � ass •�,�,;� _-\\. ;�_ ELEVATION SCHEDULE PROPOSED SITE PLAN I: INV. AT FOUNDATION = 98•0o SEWAGE SYSTEM DESIGN 2. INV. INTO SEPTIC TANK �7•�� IN 3. I NV. OUT 0r . SEPTIC TANK = ��� G© NAS'S�f4QNS'rA t3LE , 4. INV. INTO DISTRIBUTION BOX = 9G. SCALE: I"= 4(j ApkiL 19 + 5 INV OUT OF DISTRIBUTION BOX = q=33 C SZQ f 6 INV INTO SEEPAGE PIT = _ (0,0 CAPE COD SURVEY CONSULTANTS ROUTE 132 7. BOTTOM OF PIT 90.00 HYANNIS, MASS. A DIVISION BOSTON SURVEY CONSULTANTS, INC. 8. BOTTOM OF STONE LAY E R . = 68,C)