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Home My WebLink About0000 CLIFTON LANE - Health J.N C2/�'fVII fC 002 N SMEA No.2453LY UPC 12934 smead.com • Made in USA SUSTAINABLE FORESTRY INITIATIVE CoMed Rbu SOuraW CAT 0 SEWAGE PERMIT NO. VILLAGE INSS, TA� LLER'S NAME a ADDRESS vi o 1n r� As Ao do c� A o e B U I L D E R OR OWNER RemLe'd J. DATE PERMIT ISSUED 2; 3 DAT E COMPLIANCE ISSUED �aav�et i 4 THE COMMONWEALTH OF MASSACHUSETTS B ARD OF� HEALTH( ..... . . .. . . -.. -......OF......6...4�•�-•••t•`' `-�� Appltration for Disposal Works Tonstrurxiott rtruttt Application is hereby made for a Permit to Construct�or Repair ( ) an Individual Sewage Disposal System at: •---•--•-----...__-»_- .. 0...... � T tJ.- .1� r.. .... .... �..S ' . .......»«......---- »... 4.� .tiJ..l..Addre-ss, .L�!: _ .� .... ................or Lot NoN ...._._...._..«.«_«._.._.. -•• -I+�..IG ...._.... ner Address ---------------- --r.------ ..:.t. ..�- ..--•-••---.............».... .......----..........------------........-•---........-----------•---............................. Installer Address Type of Building Size Lot..... „T5--1? ....Sq. feet .-� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of persons............................ Showers - C4 YP g .......................•---- -P ( ) — Cafeteria ( ) Q Other fixture ...-•.................. ...... . ...--•----•--.......---•......_.....................-.......-.... ....... ..... WDesign Flow............. ..1... ._..... ,.--...__ Ions pew r djy. Total ily ow..........� ..........._ 1�►s. t� Septic Tank—Liquid capacity..�Pi.� a]lons Length.. Widtha - Diameter................ Depth-.... Disposal Trench—No................ Width....------------. -Total Len Total leaching q, p .... .. Length...............•--•- ng area----...---..._..---.s ft. 3 Seepage Pit No.._...../........... Diameter....... Depth below inlet....-•-------- Total leaching area.ZA.4,,.Zsq. ft. Z Other Distribution box . Dosing tank ) Percolation Test Results Performed by... .. sl ��.. F... .... Date......... a ` VU... ... . . .. Test Pit No. I..... inutes per inch Depth of Test Pit._. ._..... Depth to ground water. Ls. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ aE ............................ `k. t c O Description of Soil....----0. ---t•...��.f .t ......... ................. r.---�L EA9, W VNature 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 IITLZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has n i sued by the board of health. S Si :. 3s Application Approved By--••-•---•-------•--- ....•-••-••.... - ....... ate Application Disapproved for the following reasons:.............................................................................................. --•--....»» -••.............................•--•--•--••--•-••-----...�...].......---------.......•.........--......_..............--•----•----.......................................-.•--•-•-.....^................._ Permit No.............��. __.- 1 ..-1.�-�-.D_» Issued....�/2- ! �.-. ........ Hate :✓ .. Al � •..--w" r No� ..� 7 F.a....`.....�M..-?.rJ t THE COMMONWEALTH OF MASSACHUSETTS - BOARD OF HEALTH .....0 F......, tom .................. Appliratinn for Dispnoal Works Tonstrudinn 11amit Application is hereby made for a Permit to Construct4Oy or Repair ( ) an Individual Sewage Disposal System at: ............... Location Address or Lot No. ................... ....._\..._.. _„..;�;• wner ��.. ... .-... - ............................................ ....................... O Address ................_. a --��Vl✓� .� .............. ....•--------•....--------•------•.......--------.....-----•----........----.................... Installer Address Type of Building Size Lot--__`Z_T�..^. ----Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of persons............................ Showers p.t YP g ••---------•..............•- P ( ) — Cafeteria ( ) a d Other fixtures -------•- ...•••--•--••-•••••••-••- W Design Flow.............�.. ... �...--=-------. gallons perxperson,per day. Total dlaily flow....._..- �-�•' ............gallons. c� Septic Tank—Liquid uid ca acit ._ �" ions Len` . W P q P Y brtl► ,_..... Width. l Diameter Depth_.:_... Disposal Trench—No..................... Width.............._..... Total Len -----......._...._._ Total leaching area_.__.._............. f . x p° � � sq. t 3 Seepage Pit No. ........... Diameter....._ 1_..... Depth below inlet..... Total leaching area. ... sq. ft. Z Other Distribution box!(4), Dosing tank a Percolation Test Results Performed by....;_.,I,...... ......�..............k-..-�......G I Date.... P Test Pit No. 1.....:!�'Zffiinutes per inch Depth of Test Pit_.!A:4-°_....... Depth to ground water. Jls ��. Gz. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... 04 �;;�.�y� --•-------------•---•---- �---. ... -" ..--.•----------_-.-------.-.._........ ........._ O Description of Soil....... �........ a ,--{�t•� ................................... .... �Wit- � ��( ��.- H V ._..-------------- •-------------------------------- ------------------- ..._......... .------- .------- •-•-------•---•------ ----------- --•---- ---- --- VW ---------------------------------------••--------------------------------------------•--•------.....------•-•-----------------_--------...-••---------•......_............--•..........-•--..._......... 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 LITLZ 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: �r —•-' ,-] �`��,a✓- : 73•.. . ...................am,...... ............ ...........3...... .............A Application Approved BY ------- Date Application Disapproved for the following reasons:........................................................................................................ .. _ _ r --- - FN _.... ............... 1 !. � ../ ) ��. Permit No.. - Issued.........- .... _..... -- �'`� t Hate ! THE COMMONWEALTH'OF.,MASSACHUSETTS BOARD OF HE L1 TH k, .... 7"D "J..X3............OF............................................. ... r___1. .............. ........: Terfif trMtP of Taut pltntar THIS IS TO.CERTIFY,That the Individual Sewage Disposal System constructed (' ) or Repaired ( ) by--•-----•-•---------•--------•-•---`'-. z 1�1�/± tv r,l i ......._.... - ....._.... _ .. 1 tt ,. ... �.�'\ .••••^. ..._F n� .. 1nstaln--•I + ..7-• ......................•-q .. has been installed in accordance with the provisions of TI-TLE,_5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.. .-__-�... .�` .��_... dated...... .1: .0 Tr ....................:_-_ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................2. ._ _.. - .........._._.............. Inspector..... .^ ._._ �..�.._._..._..— .................. _ .. .............. � �-,.� ,,.. . � ..„.» .... .. _.� ____w....y.,. � .. .w r ..v...e .. ..,.... ....,. /) !� 7- 002 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH lJ c✓v n J ..OF........... _, _. > Cp-- No........................... ----------------------- -------•-----•---•-----....---- Fes........................ n�tti- urk� �unsix~�tr#iun �rrttti� Permission is hereby granted. -~...........-.... --- ... .....................•----......---...........---...----........_...........--•---•----- to Construct ( ) or Repair ( )ran-Individual Sewage Disposal System at No. -1-=° '7 - ...... .t. . :. '"/ . y. ....... Street ........... ct a !3 1 as shown on the application for Disposal Works Construction Permit_No..-.__..,. _,...r�Dated..........................A..........._.... a _.. N Board of Health r DATE............................................................................... SECTION - SEVVAGE A N\ V71fZczTFLCC>F �� -SEPTIC TANK- c, _"D"BOX - LEACH ,, p , WASHED STONE SA TF I►.� i I SOD� D FCPTI�S IN• ST4.�E'D Its ` �`v els>crL 1 r. To FbS- OUT• IN• OUT• CI IB ry ♦ \ �y, C )S. SEPTIC _L Z_GIlJ CC TANK ELEV. ELEV. ELEV. ELEV. • 1 C \. a `�CJy t. \� _ OUTtJ ELEV. ELEV. OF- T jD"I ;r ' WASHED STONE TFhT I}OLIr G,S' TEST HOLE LOG TEST BY �.6AIfLj � IC PF 1� K (IL0,N TEST DATE .J�- (7"S�0 WITNESS "-� BEDROOM HOUSE V \ \ DESIGN 2 {3E�D2cx�Ms + 1..0E►�T.H. s t T.H. 2 i .11G ELEV.o.("7 - - .ELEV. TO NO w s r u DISPOSER DISPOSER L.p �jA �511 IL PERC RATE ��_MIN/IN. )v FLOW RATE l l o (GAL./DAY Vgfr '�O i s✓ s ti eh r,f G A SEPTIC TANK (1.5)- �' _ �� If 0 AR REQ D SEPTIC TANK SIZE IRUM O . P' A, LEACH FACT LtTY �'�• . '�.• � . 0c z O :r SIDE WALL I = I ZS •I� (2;S) � 314. 2. G/a. 4; \ --.� ,�(�• � I + �'•�..�� F 10 ri f s a BOTTOM z tZ l g. x ( I o) � lam. S G/D. � \'``� •./Y ;� � ��`-e g�s.,� TOTAL' 204-. Z SF 9L. `I 1 41r Sod ED �J �. �� !�' ,�' 1►•'TE El_ 1 S,31 USE: v1�lE 'I�Z£cAST LEACHING PIT -.fLL l E.r-F VIAIA x 41 EgcF .'DPI- WATER ENCOUNTERED " ! 1r O NOTES: (UNLESS OTHERWISE NOTED) 1.DATUM(MSL)r TAKEN FR M 1of,�/n" A1Z_�. I f �DfE EXISTit� GE4�PC70L./ 2.MUNICIPAL WATER oVA1LABLE 3.PIPE PITCH:W"PER FOOT I O OF TO$5E �f/L-I"1F W QFlHo-jE , 4.DESIGN LOADING FOR ALL PRECAST UNITS:AASHO -44 ttNIJQ.,P��vI�FI � J(�I �^ c 5.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES:(1)FT. y r✓l.J✓D�1�1 'Iul1✓'QIt.IN( C� Q rj�• •��l..11.� "?—� 6.PIPE JOINTS SHALL BE'MADE WATER TIGHT ; ARNE H 11I p� 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. SITE MAN STATE ENVIRONMENTAL CODE TITLE S - O�AIA °c IL',' : y L Imo 1 A - G t�rf�i►1 'LAL!E 7 OCUS: • E .,� ` _ �,�_Est-�Y,��tz� INE f E 0 R _. REG.` N U �f r: R F: - y V E ;A4hE�'.�ft� MA.P -.�I PAC�LEI_ „- � � ;down '�ca a yen i eeria SRN s PREPARED FOR. iF�IG�E(do: lie T S EVIL ENGINE _ LAND SURVEYORS BOARD OF,HEALTH *� ,_...,..q_;,.•...4.: :•.:.:,. � .,.s..:; EXISTING) .. . M7 Y�,2Q IAaamIA 8iitli T:. . . ` o O,$ ..... L } .. p� .CUNT O GA , tm"I'll APPROVED.,* TE URS t•- %•.s:,, ,.'l .F•�F-.. ..... . _ .._-/. -.-,.._ J_.:,t ..r... .,..-.. ..... ..:.... u -....:-. ., u .. -._ ..4-_-.. ....... _..,s_.. ... .} s.-. .....__. ....._ vn'.-tml.`.. . ........ ... .t 5-i.;. i'._:N. ...,..- . ..... - - ";_S. _ _'_Y'i.- ._.