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Home My WebLink About0049 LIAM LANE - Health 0 Ufa ,� L � a4�YTvil 0 No.----- ........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 0 F...............jj� ................ Appliratiou for Uiiipaaal Works Towitrurtion Frrmit Application is hereby made for a Permit to Construct k-�or Repair an Individual Sewage Disposal System at: ....................... ....... J r............j4��........... --------- Location•A2ddre or Lot No. =,e .��E( 10, L ...............? ............................r4fV4.P_ =,0, .... ...........0 . ...................... . Address .......�.l...0.......................... Owner ....................................................................... ............ ---------------------------- Ins Her Address Type of Building Size Lot..Z-7, .......Sq. feet U Dwelling—No. of Bedrooms.._....... Garbage Grinder ............................Expansion Attic 446 aOther—Type of Building ............................ No. of persons............................ Showers Cafeteria Otherfixtures ...................................................................................................................................................... W < Design Flow..................5'.."i--- _----------- ---gallons per person per day. Total daily flow..__..........x.3_0...............gallons. WSeptic Tank—Liquid capacity- AVOgallons Length................ Width........_._..... Diameter-___-___-__----- Depth....._.......... Z Disposal Trench—No..................... Width........._...._.__.. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-------------------_ Diameter............_._..... Depth below inlet..............._.... Total leaching area..................sq. f t. Z Other Distribution box Dosing tank ( ) — Date........... — I Percolation Test Results Performed by.:---------------u::�,6_._0&im"Angm...... Test Pit No. I---C7�3��_minutes per inch Depth of Test Pit-----. -- ----- Depth to ground water_.,(Ae0 �Z4 Test Pit No. 2_444A ,mutes per inch Depth of Test Pit........t........... Depth to ground water-- 94 Z 0......................................................... 0 --J/-------------------&j Descriptionof Soil..............................................................0...............Z................. .................................................................................................. q .... - --------U ............................................................................................. --------------------------------- ------S- --------------------t�........W........;i�...................... 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 LITL2 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 o alth. Signed........... . . ...... ......... 7 ------------ e Application Approved By............. ..... ......................... ...... ............. Date Application Disapproved for the following reasons:................................................................................................................ ....................................................................................................................................................................................................... Date PermitNo......................................................... Issued....................................................... Date ad.-5 2 Fps.35= ........... THE COMMONWEALTH OF MASSACHUSETTS BOARD Off` HEALTH C , pphration for Dispas al Works Tomitrnrtiun ramit Application is hereby made for a Permit to Construct ( ") or Repair ( ) an Individual Se a Disposal System at: ................---•---- -E�-�- .. --# ... .. ........�- � .......... ......_L.- _... ..... ...... ,� Location•Address- . +'ti or Lot No. ., •- 0 Re •^'' *', Owner ------------;_ .........---- Address ��._...Y +r......... a I..... Installer Address PQ Type of Building Size Lot.. ..�.;313.......Sq. feet Dwelling—No. of Bedrooms............��............................Expansion Attic KI�A Gartage Grinder (I'1'e)o 'PL44 Other—T e of Building ............................ No. of persons............................ Showers — Cafeteria 0.i Other fixtures .................................. W Design Flow..................5................._.._•._gallons per person per day. Total daily flow.___..........�.3..�...._...•....gal Ions. tx Septic Tank—Liquid'capacityl(h Yf)gallons 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..................sq. ft. Z Other Distribution box (.� )` Dosing tank + `� Percolation Test Results Performed by--------------- ___1✓.;.f f I G!_?'" .__..___.' ?. Date...........!E6 71 ,4 1 .,.�r( �.... r...- Test Pit No. 1...............minutes per inch Depth of Test Pit.........I..... Depth to ground water..>4-._.r.Q fs, Test Pit No. 2._4 44A minutes per inch Depth of Test Pit.._..(...._...... Depth to ground water-___ .._ .............................................. J ...._.._.............................__...........4.. .... D Description of Soil.............................................................. ' G� `P ? + ... Lit = 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 TTr1'^ l I Lam 5 of the State Sanitary Code— The undersigned further agrees not to place th system in operation until a Certificate of Compliance has been issued by the board of health. a SSigned .......... ................. t............... -z = = Application Approved B - �._! .. i� ..... PP PP Y Date Application Disapproved for the following reasons-------------------------------------------------------•---------•----------------------------------------....._ -•-------------------------------•-------------•--•-••••-----••-•---•----•...•-•••---•-••----•-........._-----------•-------•--••---•-------•-----•------------••••----••-----------••-•-•••---•-•••.-•- Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Z �rr�ifirtt#r laf f�unt�r�i�anrr THIS IS TO CERTIFY, That the d vidual Se. 'age Disposal System constructed ,(s j"or Rep ( ) by --------------------- -.----------•---------- ;... -------•••••. p '.".- Installer/- _r .. af......................................................................•........:-...------------------....----------...--•---......------------•---•----..........---------•-•---------•--...••---•.... has been installed in accordance with the provisions of TIT ,` O The State Sanitary Code as described in the application for Disposal Works Construction Permit No________________________5 �>..._.. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................................................!71/1:=:Vd --•--•-•---- Inspector.......P e�.....------................................................. 1 P' 1 THE COMMONWEALTH OF MASSACHUSETTS r r" BOARD OF HEALTH 5� ...............................OF. 3S N .....................2 FEE........................ Permission is hereby granted ..r' .... -- .'..F_t_ .. .0:' .................................... to Construct ( r) or Repair ( ) an_Individual..Sewage Disposal System ` s , r .......................................................✓ - t Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... ; --------------------------------------------- ,-*Board of Health DATE----.-•-•••••. .............................g./.............................. FORM 1255 HOBBS &.WARREN. INC.. PUBLISHERS h � A LOCATION /y SEWAGE PERMIT NO• VILLAGE f IN TA , ER'S NAM ADDRESS i U I L D E R OR OWKER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED �� L6 �-�( Ea 20; ac» c • m , 1 vAOF At, I�S W r > Wir i � v JVV qZ 4 t rE fpO%7 ', Q R./ •� P• /(� '{! � - N't '. T�EpO�S�,yl�f !� EE CN r��T ri c nk x t Yq gow . 1 i f 1\ / C 1` � y•� 17:1��' �,�/�5` t�"� '�'P� i a ii s.:t �\\�:� e i jJ Uc0 A ✓ ./ is4 fiJ� s� q r ' `r k 33 alY - .. 'ter •`.. �V / � � uV �`{�S�S 4r4At(�/t L,��, � - •�. .. _ .. 11 at P W 4 Al '' 4 •T.°� !!t :r t Lo 1 • LEGEND CERTIFIED PLOT PLAN EXI3TIN0. SPOT ELEVATION :-:04 �b , EXISTING CONTOUR ---- 0 a� ;�u. m N �QT z .Lisp�1 �' FINISHED SPOT ELEVATION RSA FINI SHED CONTOUR 0-�-!— .�,�� , ��+��o��v9�� • IN APPROVED BOARD OF.. HEALTH lj DATE AGENT 4'IFYt i' �,':z `" SCALE, / =.50 DATE LDREDGE ENGINEERING CO. IN S' CLiek - - --- 1 CERTIFY THAT THE PROPOSED E61STERE REOISTLAED ps','`plUtLDING SHOWN ON. THIS PLAN CIVIL LAND CONFORMS TO THE ZONING LAWS ENGINEER RvEyQR .;OF dARNSTAB E, ASS. 712 MAI N STREET,*. `` ft.;�� H YA N N I S,. M A S S DATE R 0. LAND SURVEYOR 20 FT. M/N. /1(OTE /F E/TNER T/,IE SEPT/C TANK OR 1E.4C-0411 O P/T AttE MORE 7WA;.1 /2"BE40.4v • " /O orr. MAN ;JRAOE� A �4'O/AMETEK CONCRETE COtiER SNALL eE ,9R0C/GH7- TO GRADE.0 4/1' EXTRA GO/VCRAE7,& 9'PYC P/Pz �4E.4vy CAST /RON COVER Sf/�4L L. DE USED L v. 49S^ COYERS AWN. P/TCV /F/,v OR/1/F- N/.4Y _r /B PFR FT A s9 GO ✓ER CLEAN SAND a- _ BACleF/L L "LAYER 4M�s a IRON P/PE /C9 0a G/4L. o o o e o•'o GiF ��8 `��B b MIN.PrrC4V p/ST. • • • • • • • • > e WASHFO 57?7NE PE�s fT. SEPTIC TANK ' , s , • . . . , 1 BOX o • � • 8 • • • • • � . _ e D • IEFiEr^T/VGA f ♦ �i 3�4 ::. 4. • DEP3°H • kVASJ�lED STONE O • • • ♦ 1 • •• 1 �• o♦ • ' ` /. Ffx Z a • • o . AeECA5T SEEPAGE t Q ��Y:. f •r • • •: • • • r• . • • P/T OR eOVIV. /N!/rGRT L'tENAT/oNs rtTG4P/FGIT� S•48f+/ i . .. •. s /NYERT:.4T al//I . , ` AFT 1�/AM I T .rElo'!'JiC` Ti4NK FT ,D//4lrl: C��E TABUL.4TJON, /NLE Oa7LET SEPT/C TA/VK° k u GROMN0.P447'ZR TAMLE D/STR 8!/T , INLET aTEGT/CN OF.. � s k� 'r,F _ w 't'.O• .:'�- _'.".r ''A'.-z ."3'�' a -... ?w. t -•+;:_, .....�6 ''ss. OVTLET07STR/BtlT/ON ks - �.y /INET LEACVIIVG /177 5 FT s ATt N k 4 LEA'Cf1/NG p/T T/!:Q✓' L O ;4 - Sew L O/MEND%QN "A 3 FT k DES/6IV..CRI TER w NtIMdlER OF 9EOROOMS" 3 - �- ., „ `• G/MErNSIaN '.0 ¢"` FT:'s7 ry; .e• . . GARQAGED/SA7MMJ.UN/r .NvuE Y SOIL= LOG TOTAL EST/M�1TE0 FLAN 3 3° G.4L.�DAY SO/L: TEST/lt/ SOIL MrST�U L� SD./� TEST XUMBER QF LEACN/NG P/TS_ �`EL E✓. ¢ g -EL1i'Y• DA T'E OF SOIL TEST SIDE LrACH/N6 PER P/T l fT..,: �' RESULTS H//TNSSED dY JR�' GiFFo.xo ;9oTTOM L61CN/NG PER P/T 7� S4• F7" Lo A--�/ f.� PER(;OLAT/ON MATE�/ LeSS M/N�IiNCN TOTAL LEACH/NG AREA 2"6 b S47 fT. ISa?3s0/L )=MV 'OLAT/ON RATE A -�� M/N�/NCH REsfRv5 LEACNIMIS AREAS z —� /YjEOiv-'J I ZN OF Nq�J-� �tk OF A14 �` f�fVTJ 1OT 2,4 1-1 A 4", ALP H � MORSE Ila 29874 'No.10951 Q - �� EL DREDGE fN&I VEERING CC,INC- A/g� s T E� �`` CL.E v. M 3 2,u' 7/2 ^iN S T. , ArYAAvNS i . M,,ASS- hp SUS �Frs!ONAI��\ ® NOGROUNi7 yNi4TL'R ENCOUNTERED CL/ENT 6c�.v,srz" DATE �`3 fs-z- `' R .GRO UJNO kVA TER AT EI- _ JQB NO.• 2 C ! ! SHEET=OF