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HomeMy WebLinkAbout0022 ENSIGN ROAD - Health C,tn`re-Cvt I I e Iq7 -osl -- -- - - - - SMEAD No.2453LY UPC 12OU smaad.com • Mada in USA FORESTRY $USTAINABIE IN(Twm 6NtldWiMr souring IU LO CA Tjfi SEWAGE PERMIT NO. YIyLLAGE ' _ 1 INSTA LL R'S NA i ADDRESS BUILDER OR S� OWNER 1 � DATE PERMIT ISSYEp DATE COMPLIANC1 ISSUED D. �M A d No...... FEB 3.�!................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................OF.......... .................... Appliration for Mipaaal Works (foustrurtion Prrutif Application is hereby made for a Permit to Construct-Aror Repair an Individual Sewage Disposal System at: ............. ..........R................. .............C.:eal low.. ..... Location.-Address or Lot ................... e. ..... . ....... ......... .............06 Owner Address .......................................... ......... ........... ........................ ........................................... Installer Address Type of Building Size Lot....ZPI.YO�r' Sq. feet U Dwelling—No. of Bedrooms.----- --------------------------------Expansion Attic Wo Garbage Grinder (If4() 04 Other—Type of Building ........... .............. No. of persons............................ Showers Cafeteria 04 Other fixtures ----_------_---_m................................................M..............M------ ...................................................... !4 W Design Flow...............>.. ..................gallons per person per day. Total daily flow........... .................gallons. 04 Septic Tank—Liquid*capacity...1p.*allons Length................ Width-.__......_..... Diameter..._._...._..._. Depth................ Disposal Trench=No. .................... Width...._........_...... Total Length___................. Total leaching area------............-sq. ft. Seepage Pit No--------------------- Diameter.._......__..._..... Depth below inlet................_... Total leaching area.......m..........sq. ft. Z Other Distribution box Dosing tank Percolation Test Results Performed by.................. Fwa.... Date............... .�1/ i.__.. Test Pit No. 1.2( SI.minutes per inch Depth of Test Pit....../..-Z..... Depth to ground water... rXq Test Pit No. 2.7 inutes per inch Depth of Test Pit................ . .... Depth to ground water.... P4 .............................. ......... 0 , Description of Soil.........................0..:M.(.Y­_m'-/ ..................................... M!;::n0.,-f.. .................. ...................... U ..................................M.................... ............................M.................. W . .. ................................................. Z ... ......................... U Nature of Repairs or Alterations Answer when applicable............m------------- .............M................................................. --------------------------------------------------------------------------- ------------------------------- ----------------------*---------­­­------------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TJITILI-: 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issue the board of heal Signed ........ . ........................... ae Application Approved By-------------I.. ..........M----------------------- ................ - -- --------- Date Application Disapproved for the following reasons:...........................M..............M.M.-M............................................................... ...............M................................................................................................................ .............. .........mm­m..........M................. Date PermitNo_______________________ Issued.......................M........................M...... Date No................_....... FEs............._............... THE COMMONWEALTH OF MASSACHUSETTS , , ,. BOARD,. 0'F, 3 EALTH . .................OF......... r � C .,r:�e�" � ...................... ApplirFatinn for Uhipati al Works Ti n itrurtion thrutit Application is hereby made for a Permit to Construct,,,(`or Repair ( ) an Individual Sewage Disposal System at: �..... Locatiop.-Address r or Lot No. ✓................•-----.==:.. r' !. .................. .* : ......_. � ��.�'!' : .._. . r Owner Address �t 'h` .` InstallerE Address Type of Building �... Size Lot..�.Qa_ _.__._Sq. feet ., Dwelling—No. of Bedrooms_..._._. _________________________________Expansion Attic j�f Garbage Grinder '4 Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ..............:........................................ W Design Flow______._.... ....................gallons per person per day. Total daily flow............................................�� gallons. WSeptic Tank—Liquid capacity._t.11.(Wgallons 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. Z Other Distribution box (L-11-' Dosing tank � aPercolation Test Resplts Performed by.................. I t.....l .... Date.............. _&I-__. Test Pit No. 14~ =.(..minutes per inch Depth of Test Pit_._.. ." �.__ Depth to ground water.._ _l�AC(P . rs, Test Pit No. 2.�. ff!'_minutes per inch Depth of Test Pit-.._.ir_� Depth to'ground water--- - _ ��'�- O Description of Soil .. 1- -------------- •- ��t- r_ " .. .%' j/ ........................................................ C 2 r r p rr- �j rt J ............................ - •-----y t �i d--.....--•---........................................ U -----------••-•--••-•---....... S i�• ��-,C i _ ._tef 1 ....:_ 1 /?�^- 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 TILTI . p 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 hea the ; l( / ApplicationApproved By.................................... .......:.................................................. ........................................ Date Application Disapproved for the following reasons----------------------------•----------•---------------•----•-----------------------------•---•..............-• ---•-----•--------------------------•-•-•-•.----•-••----•-----------•-------•--------•--•----•....-•-----...... ..._...-•••.._.....-------•---•-•-•-•--••-••---•-•----•--•-•----------•-•.........._.. Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....... L✓.I ......OF.............. ............ (9rrtifiratle of f�uutpliFanrr THIS IS TO CERTIFY, Tha the Individual wage'Disposal System constructed (<) or Repaired ( ) byldpoz -' .. . .... ?'.x.5- �. has been installed in accordance with the provisions of 44 he State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dates_................................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION /SATISFACTORY. DATE....................................... I.'Lf J L................... Inspector.........12_` _e- .- ........................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........OF...............o. � .". .: .: .... No......................... FEE........................ Ropitgul n a n tr�trjt' n ntit Permission is hereby granted....................... ..........................._......... ................. ___ to Construct or Re a rr ( ) an Individual Sewage Dispos Sys eem `--F Street as shown on the application for Disposal Works Construct, n gym' No _._ ted.......................................... / k Board of Health DATE................................ '........................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS M � . LoT 2 'Lo, 405? S, F7Z TEST G1r 1co7,exw+sio.1 j p��@.fYloJ pcax a - fua0-aA. 00 �. savnc rAwK V µ p d 3y'* i 1 �-r-'-=T/TFSM E!. 43, 54.o s.+= 15� f=r F72cuTA,E FAT' -5, f3. 30' 15,000 s. F r:Ic T>< ; I nT loo Fr. wfDr-r-i LEGEND �,.... 5F CERTIFIED PLOT PLAN EXISTING SPOT ELEVATION Oro .� ,� " EXISTING CONTOUR --- 0 --- JOHN �-E- 'L _ .JS�G►.1 . �J©ALA FINISHED SPOT ELEVATION o 'RT MAQsTO►ris MILLS FINISHED CONTOUR 0- APPROVED, BOARD of HEALTH IN DATE AGENT SCALES � - �� DATE , q'2 � ECDREDGE ENGINEERING G1Q INC. CLIENT I CERTIFY THAT THE PROP SED REGISTER E E LAND Eij $`©�"3 BUILDING SHOWN ON THIS PLAN 06 NO. ENGINEERS SURVEY DR. BY, �:� E_ - CONFORMS TO THE Z NING LAWS OF B ',,rsat M 7p: 712 MAIN ST. CH.®Y$ 2.ge HYANNlSs MASS. SHEET_L OF 2. DATE ~O� LAND SURVEY R /VOTE : /F E/TNER TXESEPT/G TANK OR LEACN//YG P/T AV& MORE TNAN /2BELOJN F GRAVE, A P4"O/AA4 ETER Co VCR ETF COVER SHALL BF BRO&OH7' TO 41TAO.E.�'AN EXTRA �- CONCRGTE 9~PVC P/PE ji-AVY CAST/VON COP,rIT SHALL 13E 41SFO M/N. PITCH ML = I011.0 COVERS /B'paw FT /F✓/V DR/VEAVA Y 2 MiN. CO/VC.RL E AOE COVER CLEAN .SAND JP L/q[I/D LEVEL 2 LAYER CAST MI N.P I o00 - G/lL o� • ' WASNED STONE 1 • a .WoPCR Irr. SEPTIC TA D/ST• BOX n i p � � $ • • • •• • .•� � �. I: � (0Pno,.,h L? -, •_ / • �E ECTr✓L ' . y • • • • pEpTN • • • • • WA5N- STOiYE i s� . • • • • • .•• • ► • PRECAST SEEPAGEe' lNi�e/l'T CLEYAT/OMS IS$.SX 2.5 = 4-71 �PD �. • 4 • ., `• • • • a r •• P/7 0R ZVV/V. 79.5 x 1.O .= 77 G P D �sT. DrlAH. Iwo 91 /NYEJCT AT Bl//LD/NG 99,4 /eT ld LE7 s%lPT/C T.4NK 9g•1 FT, Per CAPACITY '`- 54q vPD I d O.G4M. CSEF T ULAT1oN, &W71.E7'SEPT/C 7ANP< 98.E fT, /NLE7.OlSTR/BUT/ON BOX `°I8.4- GROt/NO.J1ATER 7"/t�Ir f OtITYETD/ST�?/®1/T/ON BQJr 94.2 � SE=CT1aN OF - /NLET.LEACN/NG P/T 98.0 fT. SEN/AGE .O/.SOO�TI�L .SY.ST&- M „ -rA4vi)4LATI401V LEACH/NG p/T DES/6/V CR/TER/A -SCALE : /'p- O/JhEXS/ N .S Co '• a NlJA1BER OF BEORap/yS 3 D/ME/VS/ON C 4- FT. _ .r&ARaAGEO/SPOSAL UNIT a SO/L LOG TOTAL ESTIAlATEv fYOAV 3�50 G.4tD.�.1 V SO/L TEST Al SOIL AFST**,2 S®/aL. TEST MUM NEW 0-Or 4MCN/N4 P/TSB_ EtE . 1 OC•O EL1rje a4TB' OF.f0/L TEST 9•G�t � 1 S/DE Lr'ACH/NG PER P/T ��8 fT. t-,ouu RESULTS IV/TNd■SSED dY -�eE�Grf BOTTOM L.o1CH/N�i PER P/T 2? $Q. /=T. O- I$' �,pg,L AERCOLAT/OW /IAT�f I � MlI1SIINGIf TOTAL LEACHING •4REA 2(c� SQ. AFT. c�,,2sE PIf`hCOLATION RATE 2 RESERYIsrLEACNlN6AREA ?.lam $Q_ pT I8" 30 --Amp2.0 LpT 'fC o L T �� ; MA P-'5-rClW5 MILLS, RARs j-s7r sLB �o xw" � o J�AORSEMOS E$ o p No.10951 COS�rJ/ EL DREDGE EN►rrlA(" 1 V+G CV llV 90 �G/S T�� ,�`! 7/2 MA/N Sr. �Fssrclva.� 11 EL =48.o ;x;: := <q STE �� ® NO GROL/ND YYA�R ENCOC/NTfREO NYANN/3, MASS. ND 5UR��' Q GROUA/D W.4TER A7- ,EZ--'vV 1OB No. S100M 0j-4