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Home My WebLink About0067 FERNBROOK LANE - Health (2) c p' y vj o� ,4ZO2 , 0 � S M E A D No.2-153LY UPC 12934 amead.com • Wade in USA SURAKW FORESTRY INITIATIVE C�tlflod�rSourcNp lOC CTION� - 6(Wqk5 EWAGE PERMIT NO. ----.A `6' INSTA LLER'S NAMES &_ADDRESS �, - OWNER DATE PERMIT ISSUED �S- DAT E COMPLIANCE ISSUED � ,_ I � <o � � l7 `� s 1 � .. _. i F��w1 � aQ� L •� r 09 6 o No.....1�..q:.Ll..�.� �� r 'Fxs.....5 .�............. THE COMMONWEALTH OF MASSACHUSETTS �� BOARD OF HEALTH 2 0� g S ..........._7-�. %Y:.........oF........� s46, '-r.•4.T.3...�- ..------•--------------------- Appliration fair UhipmFal Works Tonotrnrtinn ramit Application is hereby made for a Permit to Construct (v) or Repair ( ) an Individual Sewage Disposal System at: . ''1—y*y111, 67 re"8 k rao l< �a7' ZZ Location_Address or Lot No. F2v �ty�p....1�._ rr C� ,z�ic ...........................wner ............................'-•.Address Installer Address _ Q Type of Building Size Lot_..7�: z_7.......Sq. feet UDwelling—No. of Bedrooms........................................Expansion Attic ( ) Garbage Grinder. aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria dOther fixtures .....-•----•------------•-•----•---•------------•--•------------•--•---------•----••--- ---•-•---•----•---------------------------------------------- W Design Flow...........-s3..................•....__gallons per person per day. Total daily flow_._......_.._ 33n__..________....__gallons. WSeptic Tank—Liquid'capacity.Z�e._gallons Length.!.K"_".. Width.:?. ".. Diameter---------------- Depth.s_'!�!" x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No........ ----------- Diameter......e�Z........ Depth below inlet..... ........... Total leaching area..3�I.sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by..... !'v .__6:- ke�G�.............. Date_.SC_'. /%g W Test Pit No. 1_.4---�c...minutes per inch Depth of Test Pit----�'• .~.... Depth to ground water--__- ----------- 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P -----------------------------------------------------------•---...-----•......--......_...__..._..••......................................................... O Description of Soil......a''.:30" woo/ 4 y Sum:Sod G. 3o y_Lb" Ce9aa sN- .S',q,�a ,2> U ..p�!�!� z- �4•• Co.9�s _-s' a.... 8¢ /SZ" D��.!I `5.9'` o.... -- ..... W x ------------•----•-•--•---•--•---••------------------•------•----•------------•----••....----------------------------------•--•--•----------------------••-----•-----•-----••-----•-----------•........ 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—The ndersigned further agrees not to place the system in operation until a Certi- t of ompliance has s e by e board o health. Signed..--•---'-- .... ------ ......... ............................................. ................................ Date Application Approv By..... .. 5bns: ---- .............................................. �� .f Date Application Disapproved for the following re ---•----•---------••-•------•...:.........•-•--•-••---•--•------•--------•----•------.......................... ----------------------•--•-••---.....----....._..-•-------------•--------...-----•----.......-----...----------......--•--•--•---------•---...............................--------••--................ Date 44 - Permit No....<?... _12� ---------------•-------- Issued-............. - r'I .I ................ Date _ t s ' r o � N THE COMMONWEALTH OF MASSACHUSETTS 20 g BOAR® OF HEALTH 2 0�' g 5 ......T►n/N..........OF.......8 7zn/S�i9 G6 Appiiration for Disposal Works Toustrnr#iun amit Application is hereby made for a Permit to Construct•(—) or Repair ( ) an Individual Sewage Disposal System at: .... Location-Address or Lot No. - ....................... ..........•..........................•-....... W Owner Address a l..� �----------------------------------- ....... ----- ..................................................... Installer Address Type of Building Size Lot_.3�j../.Z2...--...S . feet {` Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder le l� aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria a' Other fixtures ...................................................... W Design Flow........... `�. ..........................gallons per person per day. Total daily flow__•_____._._.33 ___._._ ............ WSeptic Tank—Liquid capacitylsee_-gallons LengthA__'�_ Width¢_G_�.__. Diameter................ Depth.:L�5�!.�. x Disposal Trench—No..................... Width.._..____........... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No._____1----------- Diameter-----lz.�_____- Depth below inlet..... ........... Total leaching area_3_.L_sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by.---__ .:_ E?-� `:............... Date.s�. ,.� >r . �---•-----•-------- Test Pit No. L-4..z_...minutes per inch Depth of Test Pit...1 ."._._.. Depth to ground water-----'----__---__. fZq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 --------a---"-------------------------------------------+-6--------••--•-----.----------------•-•----------------------•--•- - -------------•---------- W0004!)�,- �5c .5oiC. 3o_'_La" Cd.v-lzsE- 5: aO Description of Soil..._..4 ''�3 � --- ----•---••-•-••------••-•--•••• ..........•--••---------•-- x i7i3�iNZ ". ..e4V . Coi-Y. E SAS. ........ ''¢._._"�SZ " �`iNuh . -----------•--------------------------••---•-•----------•-- 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 TITLE 5 of the State Sanitary Code— Th undersigned further agrees not to place the system in operation until a Cert* of ompliance hae >e b the board of health. Signed._—- _ !" '6` �✓G"' " ---• •-----------•-----...-•-------•------•------- •-------•---Date ......_.... Application Approv By._..Y _. ,, -_.-_--_-_. L ----------------------------- -------- '=i/. 1-----..... Date Application Disapproved for the following r sons---------------•----------------------------------------•------------------------•------------------------....._. ...-•---------------------------------------••---------•-----------•-••------....--------•----------•---------••-•---•--•-----•---•-••-----••--•-----•••--••---•----•......-•-----•---••---------- Date - Permit No......................................................... Issued.....-................................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........TW Al.............OF........G,?i�J2r✓,STD.�3G.�................................ Tatifiratr of Tontplittnrr THIS IS T CERTIFY, That the Individual Sewage Disposal System constructed or Repaired ( ) by-------------------- -------------------------------------•--....-----------------------------------------------•-------------------------------•----•-•-----....._._.._..... I s ler has been installed in accordance with the provisions of TITIF j 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 CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......... — .. ... Inspector......_ ..._..4 ...........` '"= THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH /4tAIA OF..... 3c3 �tiSTi`J�3L.e— No - 5 ...... ........... ----•................ FEE... .............. Disposal Workii Tono#rnr#ion rrmit Permission is hereby granted------------------ .--------.-----------•-----•--------------•-•-------------------.......---------.................--_-•--- to Construct (' r%Repair ( ) an iudividual Sewage Disposal System at No.. _...... - r-z == gin ~ . - ...................................... -- ,- Street as shown on the application for Disposal,Works Construction Permit N ..................... Dated.......................................... .........: .... r------•--------•-•--------....-----•------------_.... ..d � R-� ..... Board of Health ---- DATE.----- ----- •-------...-•---•---------•---•---------.. FORM 1255 A. M. SULKIN. INC.. BOSTON - z'i r,. e Sf/EST / o,c Z SN4--Z77 S �y`�P�TH OPM �`7Zf✓Q200 lG �O EDW �, L'Gy7./Gr -T CtI- N KeL'LEY 1 Zo p2/V. i t M.26100 Z G/STEP e SUOV ILA � I \14 ,. i ^ I �ZbV 7vp of S7� V—dF Z3./o /i YJ Art � /' J• .. 7 �� by / l /3+ Av vjj ' � �� LoT-l' Z S P°50--,- �t�' I 7! k�Mz,2 6v PR%6 rro IAI n/ �' ez& V� iv 1V , CV 101 z `� , - / �o oil 3s/Z 7 Sq� �T. /.07 a 2 L-Z4vH77afV.s /3A9�s&'D O / Si TG P� �✓ LOCATION CfTZ72�/iGL�- !LJ�95s. ►%� 2 / ��/ f �� SCALE . .�.��' . . DATE SEit?T /y8¢ FLAN REFERENCE .,66?A16. �oT 7-3. . . .. . . . . . . l l -SVoWV oti L,19711v / I CERTIFY THAT THE / SHOWN ON THIS PLAN IS LOCATED ON THE oROUND / AS SHOWN HEREON AND THAT IT CONFORMS TO THE / SETBACK REQUIREMENTS OF THE TOWN OF WHEN CONSTRUCTED. DATE : . . . . . ... . . . . . �'/0EL UD - PC'T/7-,,/0NL-;e REGISTERED LAND SURVEYOR e -49 00 TOP OF FOUNDATION CONCRETE COVER 6 CONCRETE COVERS "0 4' CAST IRON II ` °'. OR SCHEDUL E 4b2 MAX. 12"MAX. P.V.C. PIPE 4 SCHEDULE 40 PV.C.(ONLY) PITCH 1/4"PER.FT PIPE- MIN. LEACH PITCH 1/4"PER.FT PIT PRECAST 0 o INVERT ° Q < LEACHING EL.. 00 ,. INV RT INVERT o . T ; PIT OR o'o SEPTIC TANK S DI ST. Z� W EQUIV. EL... .. .. EL....c.... ?x e INVERT "INVERT 80X . Soo., .. GAL. d' �'a p' 1 EL•¢G.43 INVERT w o o; ;.�; 3/4"T0 11/2' EL...r..... a. WASHED w STONE PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE SOIL LOG WITNESSED BY : DATE TIME. .��3c?!9'7 ToyT/ TCoB� .L?S• BOARD OF HEALTH TEST HOLE I TEST HOLE 2 G�Ia/92zD ENGINEER ELEV. . 49•/0 . . . ELEV. .. .. . . . . . . MAP30" Sua DESIGN DATA ' GZ,4G•LV ' co�s� s�o 3 • NUMBER OF BEDROOMS e'L,40, TOTAL ESTIMATED FLOW . . 33o GALLONS/DAY BOTTOM LEACHING AREA ��3,�o . SO.FT. /PITIC.P.P, �z•4Z./co SIDE LEACHING AREA . .ZzC•z SQ.FT./ PIT�szS,SC,P.D, LfD_ GARBAGE DISPOSAL yE �� . . .(50 % AREA INCREASE) t1 SAn/D TOTAL LEACHING AREA . .339 3 . . SQ.FT 31 ,/o PERCOLATION RATE l-E 77/'g?�! 7-WP MIN/INCH LEACHING AREA PER PERCOLATION RATE . . . . . . . SQ.FT/CP.D, .... —WATER ENCOUNTERED NUMBER OF LEACHING PITS .GN� ,�lT , GVi•Tt,/ APPROVED . . . . . . . . . . . . . BOARD OF HEALTH7'� � � T, •�� `S/�'U�" ®!�! LJLG DATE . . . . . . . . . . AGENT OR INSPECTOR SH OF OF ✓ os1� s� .;, E��D s � Lo 7' `Z Z Its E HY ft I � Na 26100 y A/4S S. eq GISTS UB�It, , rr Vt% y. �S PETITIONERC�e474V