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HomeMy WebLinkAbout0062 NORTH PRECINCT ROAD - Health wool M■■■■■■■■■■■■■■■■■�; ■■■ ' ■■■■■■■■■■■■■■■■■■1 ■■■■■e■■■■■■■■■■■■■�I�rilii�il�■■■ii�ii�iiii■■■■■■■■■■■■e■■ee■I re■®■■■■■■■■■■ ■■■■■■e■e■■■■■■■■■■■■■■����Now ■■■■■■■■■■■e■■■■■■■■■■■■■■■■■■■■■■■■�������OEM AR7`1/ PREci;#I i RA � � �l 6 C� LOCATION SEWAGE PERMIT NO. CT�� VILLAGE `pv� Sn''/If� ,y Ser3 �.✓L �i3 /�df,vro ��c�� D��iyi,S . Mrlsr IN.STA LLER'S NAME i ADDRESS c3�o BUILDER OR OWNER . lz► DA T E PERMIT ISSUED DAT E COMPLIANCE -ISSUED AW J lys,6 7 Fss..........d................ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ........ ................................OF.......................................---------------------•--........... Appliratinn for BirVnial Workii Tomitrurtiun Frrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: a.r...C.. .Nt�n lf.-.... =----------- f :--....................................................... ocation- sess •-•-_.•..-•.•••-•••-•--•-or Lot No. --- ..........l �t .� ...... ..« ................................ .........-- ••-••..........•-••-•••--------••......----.........•. W /L!-......Owner....... wner 14 ---------------------•--........Address Installer Address Type of Building Size Lot_o20f 0 5AI__.....Sq. feet Dwelling—No. of Bedrooms......_3................................Expansion Attic ( ) Garbage Grinder (Alit) aOther—Type of Building ............................ No. of persons............................ Showers Cafeteria ( ) a' Other fixtures .....-----••-••-----•............. Design Flow............................................gallons per person per day. Total daily flow.._.........3.3.D.....................gallons. W WSeptic Tank—Liquid capacity/a U_O.gallons Length---------------- Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width....... Total Length............ .----- Total leaching area....................sq. ft. Seepage Pit No......./........... Diameter.......ld�....... Depth below inlet................. Total leaching areaYM........sq. ft. . Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed bY---------------------- ....................................... Date........................................ Test Pit No. 1................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........................ P4 --•--•--•-••--•-•---••------••--•---•---•---•--•-•••-••--•-••-•--•-•-•-•......--•-•.......................................................................... ODescription of Soil.......................................................................................................................................................................... V -------•••--•-----.....-•----------•---•----•-••---••-•-•--•---•-•••----••--•-•••-•-•----•--•••-----•----------------••••-••--•----••---•------•----•----•---•••••--•-••-•................---------••••. W V 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 IT::L 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Com Hance has been issued by the board of health. in = ---•-.........--•--•----- ................................ Application Approved BY = ---• Date Application Disapproved for the following reasons---------------------------------------------------------------•---------------•-----------.................... .......-•-------•------------------------------------------------------•-----------•-------•-•-------------•--•-----•---•-•------••-•--•-•---...••-•----•••---••-----•----•--•-•----•-----•-•--•..._.._. Date PermitNo......................................................... Issued....................................................... Date S;5� l�I ~` THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF_......................................................................................... Applirution for Biopoual Workri Tomitrn.rtiun rruti# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...//)t......_... . err ;-��'�:...................................................... (,, gig `I ocation/A/{1fdc/ess - or Lot No. Owner Address .................................................................................................. .................................................................................................. Installer Address Type of Building Size Lot__ L,,�_U_s),_?-___-_Sq. feet Dwelling—No. of Bedrooms_______._...............................Expansion Attic ( ) Garbage Grinder (tip) Other—Type of Building ____________________________ No. of persons............................ Showers (,Z) — Cafeteria ( ) Other fixtures ..._.... --- ----- ---- W Design Flow_._.._______�r_ _______________________gallons per person per day. Total daily flow___...._._._ . .....................gallons. 9 Septic Tank—Liquid capacity_4Q_0.Llgallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area_.-_____....__..._.. q. ft. Seepage Pit No--------/----------- Diameter........1/.4,....... Depth below inlet....... Total leaching area39........sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minute`s per inch Depth of Test Pit.................... Depth to ground water........................ fz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ----------------------------------------------•----•-----...........------....._----•-....-••••---•-......................................................... ® Description of Soil.......................................................................................................................................................................... ----------- ... U --------------------------------- W UNature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________ ----------------------------------------------------------------------------•-••----------------------------•-•---•---•-•-................................. ........................................... Agreement: .The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with provisions of iTT the p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Com liance has been issued by the board of health. in --- 2..... -• H p -------------------------- -••----------------------------- f / Date Application Approved BY-- •"--.---. •.ti"��* �"',r1e...._.....--•-•--•............... ......e%1�1_00*----------- Date Application Disapproved for the following reasons:................................................................................................................. --------------•--•---•----------------•------•----•--•--•---.......------•-----------...----•------------------------•--------------------•-----•••-•-•-----------•-•••----•--------•-•-••---•--•------- .• Date PermitNo............................................---•-------- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD: .OF HEALTH ..........................................OF..................................................................................... (9rdifiratr of T"anutpliattrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by• ......................................... -•-•--_-• .... . ...-••-_.... •---.....----•...........................................•--.... Installer F has been installed in accordance with the provisions of TITLE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No__-_:c�«!l".d�r?_l0..._......... dated..........................-..................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® S A GUARANTEE THAT THE SYSTEM WILL U ION SATISFACTORY. DATE._../1..........__ Inspector =- �----••.............................•••---•...••. P . ......--•-------.._... ----....._._.....-••-•-.........•--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF..............................................---•__•__......_...._........ No..��dY_e.... t FEE.-. � wispog l Works Tuunutr inn rruti ,fn �..:.. Permission is hereby granted........../L..,1h.,._........j-�.._.-------••------••---••----------•-------------..........--....._..........---•--..... to Construct (11_�or Re air ( an Indiv ual Sewage Disposal System atNo.. .. �1 r ............. "'___ !' ............................................................. Street as shown on the application for Disposal Works Construction Permit No_____________________ Dated ________-_____-________--_______-------- DATE.................................. V- ..A •----........... Boar of health FORM 1255 HBBS & WARREN. INC:, PUBLISHERS TOP VIEW NO > D E M VIEW SCALE- NO A E ® INLET �.�. ���1" n4111F11,.k: WA�.)'fJF ) STONE r LL LL LA- LL L- 3/4so- 1 1 /2" DOUBLE 17 WASHEU► STONE 4w t FREE OF !RON , F (NET, L L DUST ` > \ `217 / PIT LINER �` P-64 '� / / /CONCRETE--BLOCKS----0-R PRECAST . 357 438 „�• / _524 TYPICAL PROF I I~ E NO GALE ��� `618 MANHOLE TO GRADE IGHT JOINT PVC ,� _ ...x.,• r ' .,v �_"_f --�-- -`"t- ----� _ MANHOLE T 0 GRADE- AA _ OD -- - --3____ BEDROOMS -_E? PEOPLE B8 CC - FF --G PEOPLE AT C-GGALLONS PER DAY PER PERSON 3!!GALWNS --- PIT LINER WASHED STONE PERC. RATE -_Z._. MIN. PER INCH - SQ,FT. PER GALLON 4« 71®NT JOINT PVC � � ------r-_—_._.___-._.____ Sets. sE.Lo.r.wo __.._.._CA9T IR _SQ F T PE Ft C,A!..L_U N - ;Ca f T 1 INIMBT- 10' pIV �f� < r __._,._.__. PRECAST CONC, SEPTIC TANK USE. ' _F"� <)F `;TUNE �43 .f-T. _SET LEVEL • STABLE BASE USE tM- (;A!-'-ON SEPTIC TANK PROPOSED INyERrS BEM.H MARK CB/�aa_��D Ioo.av A.uvmIBp 'baCrot-4 �A .,..�vra. 4-p EE �� FF _��6o z,3 �ca.s Epp/sue _ �o�zr.s �� � � ____ _� 1-4 jr 165 80�trw•I T�3'i` ®�1 .3 'D�.�r 1 G 5 r' n ' -PIT' 93.Go GPD � m 0 i r ; o Af I r . .- pt% o A 13 I- �, s r z ; --i o m z z N � X I 1♦ I t, -I d ' lb 2 rn Jb © �♦ m 0N N i z ram- m r P O. z I Z. = +y •• S 0 • y 1 'rrrMwc+MNt+iN�'Mr.a.Y,iMWk r.r.:vm,„.e........ .....•.. .s.;,.-.....«.,..--..s..wr_ ......, ..,... .a.-..-.. .. , �,S`;.�A•...��.�KN7M�.A. . .. + ..w .J. .. f .. ` i X: • r • r ' .l,. .. , ��I4i. _. -. _ _ ...... .,....•1'.....a...•. .e m..0 gip' 'M_. w � � ,