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Home My WebLink About0029 DOLAR DAVIS ROAD - Health Nv;s c&terd(118 G L O C A T-I-O-K- SEWAGE PERMIT NO. YILLAGE� � I N S T A LLER'S NAINE A ADDRESS 8 U I L D E R OR OWNER L F DATE PERMIT ISSUED DATE COMPLIANCE ISSUED J v R G OCl— No....�.5. 1 Fx$.......:5 .......... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..............OF......... ( S ._ ......... Appliration for Dispnstt1 Works Toutitrnrtion ramit Application is hereby made for a Permit to Construct (V) or Repair ( ) an Individual Sewage Disposal System at: .......(.4_?.`�...(rd t L b cy�P� 1Z... ?.��i�.S �l? - ` r,--O I- r -- \_,1Z-f M-�........... .. Location-Address a t ...............1 ._.f1�. ......�s?�:` .... ?. ....... .t - �Jl..---.............................................. Owner a �--- Ad s a / .1.v --...�.%I�.l`�. ..IY�l ! 1�J-'........... ��..1�..1_�v.�.v!I �--�... • � Installer Address UType of Building Size Lot.... �� .....Sq. feet Dwelling—No. of Bedrooms........................................Expansion Attic ( ) Garbage Grinder (f�j Pk Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) OtherfiLNtRres ......................................................------------------------------------------------------------------.........-•••-.........•••••• W Design Flow.............."1 2�......._..............gallons per person per day. Total daily flow_._......_. .!2..................gallons. WSeptic Tank—Liquid capacity.,!qeU.gallons Length... Width................ Diameter--.--_.__---_--_ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.._......._.. Total leaching area....................sq. ft. Seepage Pit No.............�._... Diameter........td.... Depth below inlet............... Total leaching area.7!7......sq. ft. Z Other Distribution box ( ) Dosing tank ( . �' .J iC�l(- ®c ._ Date-----i i a Percolation Test Results Performed by. _.�Y.............. .. `l____----- -----------__-___. . •.___..... 04 Test Pit No. 1---- /minutes per inch Depth of Test Pit-_--_1 ....... Depth to ground water......_____J......... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a+ •--••••........ - -------------------------- O Description of Soil..._....Q.-Z. ' St7ol�` C�t �J1 4_ ..._�7!4� W =Pry Mt 7 ......_.. 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'I'LL 5 of the State Sanitary Code— Th undersigned further agrees not to place the system in operation un '1 a Certificate of Compliance has bee e the rd of health. f Signed-•-•• .............................................. l�/.� .. .... ate Application Approved By•••••••••rA�-----_ .... •--• ••-•••-•••-•......••-•••-•-_. ..•- Date Application Disapproved for theineasons----------------------------------------------------------------------•--------------. ------------------------- ----------------------------------------------------------------•----------------•---------•------------------------------------------------------------------------------------------------------------ Date PermitNo......................................................... Issue(L....................................................... . - No---- Fss.............................. THE COMMONWEALTH OF MASSACHUSETTS T t i BOARD OF HEALTH �j..t->..�....... ........OF........ ........................ . ApplirFation for Disposal Works Tonstrnrtinn Frrutit Application is hereby made for a Permit to Construct (V ) or Repair ( ) an Individual Sewage Disposal System at: 0 1 h it F� TD t�`j 1 S n G � v 1 l\„� M-� - ... .... . ...lam.._------. ------. -••••--•--•---• ----•-- .�' ................................. f ------............----- Location Address or Lot Itio, ----1= - ` �1 .............................................................\ �..� 6�6Owne h2if Add e --••-•...... ....... ------- Installer Address h v L/ U Type of Building Size Lot__________________________S q. feet Dwelling—No. of Bedrooms.__________.____________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other ;tares .................................. W Design Flow________________h________________.______gallons per person per day. Total daily flow........... ...................gallons. WSeptic Tank—Liquid capacity'_Qg°__gallons Length______ Width................ Diameter---------------- Depth................ x Disposal Trench—No_____________________ Width.................... Total Length.........__-�__.____ Total leaching area.....................sq. ft. Seepage Pit No_____________ Diameter.......�_d..... Depth below inlet_..... ......... Total leaching areZK47......sq. ft. Z Other Distribution box (✓ ) Dosing tank ( a Percolation Test Results Performed b ��e� 5 vC. Date.__._�. ........... y ----•••--•..........-----•-----•-•---- a -Test Pit No. 1.... .r minutes per inch Depth of Test Pit_____ ........ Depth to ground water-.--- .__._.._.. Test Pit No. 2___.............minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of Soil O S c;3�:`�1 L �— G'P �' �``l-` f `� r`)�� ` -(a A V .L 1 ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•--._..__..._. 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 TITLE 5 of the State Sanitary Code- TWe undersigned further agrees not to place the system in operation until a Certificate of Compliance has beery y� thpb and of health. Signed_._ J.i,. . `. ............... ate Application A roved B av:^ Date Application Disapproved for the following reasons______________________________________........................................................................... --•••-----•-••••----•---...•---•-•••-••--•---•--•--------•-•------••-•-•-------•---•••------------•--••----•----------------=---•----------------------------------------••------•---------•-••--------- Date PermitNo......................................................... Issued-........-.......-......................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ 47 ,__ q- A .....................OF...... .�L ..�._./l' .,. ?...f... ................................. Tnrtifiratr of Urr TIJIS ISXO CERT FY, Th�t.the Individual Sewage Disposal System constructed, k,�j or Repaired ( ) by . --...----- ...._..----• --•--. ..---------••-. Installer r r _ B z3 f j 1 ....�-�� ............... ------- `.i/',.it° f ..s? t .L ! has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE,CONSTRUED AS A GUARANTEE THAT THE SYSTEM L ' FUNCTION SATISFACTORY. DATE..- .................................................... Inspector.... � ---------------------------._..__......._._......-•-......-•-•----- THE COMMONWEALTH OF MASSACHUSETTS i BOARD OF HEALTH OF....P:�,tU.. /�.f:5.............. p p No.t?.._.�....... ---•- FEE'::Z ............ Disposal Work Tnnptrudion rrnti# Permission is Hereby granted r ,'� '" ` ,&f.......--•-••-••----•--•-•-•................ to Co struct.�O) or Repair,( ) an Individual Sewage Dtsposa ,al S�pstem t 6- ll „_. _._ Street _ as shown on the application for Disposal Works Construction Per •it No -`-___ F_I._ Dated__ _'!r DATE .------ ---r-----•-••--"----•--•-............................... Board of Health FORM 1255 HOBBS & WARREN. INC., PUBLISHERS / SITE PLAN SHEET I OF 2 SCAL E.. I z'g 4, 17 s, SzX d Z ' Ila 14 uJ tO_ tit 16 �Cr=��- o-(13 rn✓i �7 co�c . 4$! 8 �a, Cv 15 V 7- titi Q$I i � 4 s 15� e'0 SZx7 33. � r OF Y WILLIAM M. t, '~ �V LeL.J 4 1 c WARWICN No. 19771 per r�` IST ��.,Q• ,e. mt �0es►svvv OR REGISTERED LAND SURVEYOR L(71- 6 140 r�U L A, {z V V t ZONE' G k t.J T , N , PLAN REF. DATE 2 / IAi- i '?- J BENCH MARK DATUM L)Mt;2 WM. M. WARWICK 8 ASSOC., INC. DOMESTIC WATER SOURCE --rayio w�"� � . 80A' 80/ - NORTH FA L MOUTH FLOOD ZONE. C'Ja3 - A-A�'`Z�''�� eC-aa MASS. 02556 - (617) 563 -2638 �E-ACHING BASIN SECTION NOT To SCALE Shce/ z d7Z Z 24"C.1.MN COVER EARTH FILL BRICK AND MORTAR COURSES AS RE0a TO BRING COVER TO GRADE INLET, B FLOW L/Nf_ "TO "WASHED PEAS TONE FREE OF IRONS, FINES AND DUST IN PLACE J 3 OPENING W/rH 4%B" "1.. 44' „ TO I%p"WASHED CRUSHED STONE FREE OF OUTER O/AMETER IRONS, FINES AND Dust /N PLACE AND I'P4"INSIDE DIAMETER • I CONCRETE T• OB E4 00 OP•..- PSI 28 DAY. . S ` 2. REINFORCED WITH Sill roll NO. 6 GA. W.W.M. ' & .21 AND 4' SECTIONS ARE AVAILABLE FOR \x GREATER D€PTH% REQUIREMENTS 40 r` 2 —s'o" v, I 2 4. NUMBER OF PITS REQUIRED ov nr/N. EFFECTIVE DIAMETER NOTE: v EXCAVATE .TO ELEVATION 39. OR (NOT rO EXCEED 3 rlVCS EFFECr/VE DEPrH/ LOWER AS REQUIRED TO REMOVE ALL µ� LOAM AND CLAY BENEATH PIT.' REPLACE TYPICAL PROFILE EXCAVATED -MATERIAL WITH CLEAN GRAVEL TO DESIGNED GRADE." /B"STD LT WGT. C.I.MH COVER y3 d •; 'z 52• z 3 a: 4"C.L PIPE 4"B/T.FIBER P/PE DWELL/NG FLOW LINE TIGHT.JOINT OUTLET LEVEL TO FIRST ✓DINT ..r• 5d,00 'v i /4" 00 0 01 U p 0 1 1 C./. TEE 1 1 U I O 0 1 1 .110000 00 .11 11 �1'9•/v .' TO. PRECAST CONC. . s}%q : 1 1 1 000100 1 1 1 1 GAL.SEPTIC TANK: D/ST. BOX TO BE �}�f•OO I I 1 0 0 0 0 0 0 1 I I INSTALLED ON LEVEL, STABLE BASE r 1 D 0 0 0 p 0 4 1 i I -- �---� •: 1 11 100 o 0 1 1 1 1 sEPr/C TANK r0•BE 1 I 1 000 O 0 D 1 i 1 /NST LL D 0 LEVF•L, 1 i 1 100 0 0 1 1 , STABLE BASE. 1 I I 0 0 0 I O O D 1 1 1 r 1 It 000 0 0 1 1 1 1 L EACH/NG BA Sint , I 1 e 0 O 0 0 0 I 1 , BASE TO BE L EVEL 1 10,00 00.1 1 , , SOIL AND P£RC. DATA 44• 0' PERC. RATE �'z MIN. /IN. 0 TEST PIT NO. F 377�, 011 TEST PIT NO. 2 TEST BY : O-P&UGe- ++tI I.D 2' _rf? /svVh01L g 64 ZA V mil, WITNESSED. BY: I;La� L.II DtzP h�.1up �rzavr�l,�---t TEST PIT GR. EL. `�Z G�kJ MEp►Lm DATE:— ND 64r_ND•WA�[� QES/6N 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 EFFL� E_GPD• PRECAST REINFORCED CONCRETE UNITS. SEPTIC TANK I000 GAL. ,ALL .SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE SIDE WALL AREAK 5GAL./SQ.FT. TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE, MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF BOTTOM AREA 1•Q' GAL./SO.FT. SANITARY SEWAGE EFFECTIVE ON JULY I , 1977. LEACHING REQUIRED_.2_SQ.FT ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD ACTUAL LEACHING AREA . : OF HEALTH. Z-?.SQ,FT. AT -COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. PITCH ALL SEWER LINES 1/4" / FT. UNLESS INDICATED OTHERWISE, JF�,SN OK�fqs � •.MARTIN SEWAGE DISPOSAL SYSTEM • �� .�yG\ :, L�� . aD E. L - O L,L r4i MORAN - -i°i,� f23417 5 CZ O�Fscccrrn E�� _L t'__0T�Z SCALE AS INO/CATED DAre_ ' WM M.. WARW/CK 8 ASSOC., /NC, 8OX 80/ NORTH fAL MOUTH PROFESSIONAL ENGINEER MASS. 02556 - (6/7) 5 65-2638