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HomeMy WebLinkAbout0113 NOTTINGHAM DRIVE - Health 1 13 pa 3TINGHAM -DR. , :'CE{VTEVILL.E r _. _ .. •;_ .rare" d �`• ®14. rR1 ,- :92543 .53LOR �i,:STINGS.EAN w .AVI ............ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ........................................OF................................_......--------------. ...._.--.._......_..._... .Apure#inn for Diipnsai Works Tnnitrnrtinn ami# Application is hereby made for a Permit to Construct (LII/or Repair ( ) an Individual Sewage Disposal S stem at - catio - dress r - x..w �._-..flue,/--------------- . ..... ner,S��s ----- ......... .. . Ad % 4................�d ................... Installer Address Q Type of Building Size Lot----4.O v_.Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder QV,0) aOther' Type of Building ............................ No. of persons._._........................ Showers ( ) — Cafeteria ( ) a' Other fixtures _________________________________ Q -------------•-------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid*capacity//.61 d.gallons Length................ Width---------------- Diameter................ Depth................ x Disposal Trench—No..................... Width-................... Total Length.................... Total leaching areac-�?.2.0......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......... ............. ........................ Date.... e _.__..� Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water---._._____-_-__-_..___. { G� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ..................................................-........................................................................................................... 0 Description of Soil..................................---•----------------------------•-------•-------------------------------------------............................................. x U ---•----•-•-•-•-----•------------------------------------•-••-•--••-.......------..............---•-••---------•-•--•---••-•----------------...--•------•----------------------------------•------- 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'L i p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until ArjCert'ficate of Gpmpliance has be sued by he board o ............._iea Dat Application Approved By....... ..... �'..... . 111 Date Application Disapproved for the following reasons------------------------------------------------------------------------------------------ --------------------•- --------------------------------------•-......-•-•-•---------------•--•--•-•--•-------------------------•-----------------------------•------------•-----------------------------------•--•-----•-----•- Date PermitNo......................................................... Issued....................................................... Date © X a 1 No. , j ./.. ~ Fmi..... .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .------...................................OF...........................----•---......--- ...................................... Applirta#ion for UiiivniiFal Workii Tomtrnrtion am' d Application is hereby made for a Permit to Construct (k/or Repair ( ) an Individual Sewage Disposal System at E_ ...._. atl .....V It-------------- Owner ss .. (�.K1A+fie s , 1 J ` Instlaller���f.+a� • .......... a d ............. ,�a a `+ai•t Ad ress UType of Building Size Lot_..._ t-.V._------.-.Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) p' Other fixtures W Design Flow............................. ..._•_.gallons per person per day. Total daily flow........... ....................gallons. WSeptic Tank—Liquid capacity/jO�4_gallons Length................ Width---------------- Diameter------__--___: Depth................ x Disposal Trench—No. .................... Width.................... Total Length..................... Total leaching area . 0:.....sq. ft. Seepage Pit No....I------------- Diameter--------------------- Depth below inlet....,................ Total leaching area....................sq. ft. z Other Distribution box ( ) Dosing tank ) a ' l � '~ Percolation Test Results Performed by..........1 ___.._ . 14...- ...................... Date.... ...... � ..a Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gr4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P1 --•-----••••...............••--••----------•-••-••---•---••-•--•----•-----•••••••--------------••--......................................................... V" Description of Soil......................... V .--------------------••-----•-----•--......••-----•--------•-•-----------------...---------------•---------------••-•---•---------•--•--•---- W UNature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________ .......................................................;................................................................................................................................................ Agreement: The undersigned agrees to install the afore*cribed Individual Sewage Disposal System in accordance with the provisions of'TT LE 5 of the State Sanitary Code—; he undersigned further agrees not to place the sysm iia �P" operation until er cate of mpliance has be s5ued by,he boardd o�hea ed--- =cam - / D tee Application Approved BY--- ......... -= n, . . a�.' ,f ' .. Date Application Disapproved for the following reasons-------------------------------------------------------------------------------------------•--•-------------- ------•-------------------------------•---•----------------------•------------•-------•-----•-•--_"'--.....-----••--------•-••----•-------•-_.....---- ------------------------------------------------ Date PermitNo..................................................------ Issued--•-----••-------..................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF. �Y' , , (9rdifiratr of TautpliFanrr THIS IS TO CER,TIWY,�yThat the Individual Sewage Disposal System constructed (�or Repaired by : ..........� ----------------------- .......................................... --•-------••, ------ �prosions nstaller has been installed in accordance witTIT;..' 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 WILL FUNCTION SATISFACTORY. - �.� ""^° �' F•� .�- DATE -----•---•--•--..;�O./�,�-�----------------------- Inspector............. �i-TT--........................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF,,,,HEALTH N > ,( FEE.. .......... MoVapFal Worko Tnni#rudion rrntit Permissionis ereby granted. ------.....— 'm`---------•-------------------------------.-----•------......-----•--....-•---.............--- to Construct ( ) or Repair ( )° an Individual.9 e Disposal System , ........•••--•--•- ----C f" 4--•---•------••-•--•-•---••--------•--...- Street as shown on the application for Disposal Works Construction No..................... Dated J ...................................... Boar ealth DATE................................ ..... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 4 • r _ Z. 3 ell b r IT' 371 LoT // 3 a�y 0 SQIP77C [T3 7J1-W-�� frofiw.0AT10u. \ )fsr i 69./ Papnsea s�ac� _ l 3s'f 32•' nrrz p2f�ooSOD DeiV� d a LoT A6// 4 No7�- Ezev.�o••s B.4sa� o.v stssuH6'D D.9�Tv"7 CERTIFIED PLOT PLAN _ - I LOCATION C_ ivT7z EDWARD E. KELLE'( SCALE ./��- 30; OA .y ' TE. Z3 CUMMAQUID, MASS. 02637 PLAN REFERENCE .Be7NG LoT !/3 e,LWit f : I GERTIFY.THAT THE tRisTiniC �a�...D!4Tlo... ''> 5°�'•`!� SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS M THE SETBACK REQUIREMENTS OF THE TOWN OF l3A�Z.�STA�G . .. . . .. WHEN CONSTRUCTED. �'i9Z8E�T 2E�9GT3/ %7LC.5% DATE i`1A Z3/y8/ PETITIONER: WG-37 G � REGISTERED LAND SURVE R y Z. /o TOP OF FOUNDATION CONCRETE COVER CONCRETE COVERS 4' CAST IRON 12°MAX. 12"MAX. • • PIPE (OR 4"ORANGEBURG(OR ECUIV.) EOUIV.)— MIN. PIPE- MIN. LEACH PITCH 1/4"PER. . PITCH I/4"PER.FT PIT PRECAST ° -� LEACHING PIT OR EL.�4: ... INVE INVERT • • e•� SEPTIC TANK �r� DI ST. ,..a INVERT EL.Ar..9. .. BOX ELGSGS ;A� >= 0: EQUIV. 66 /G boo o .... GAL. INVERT �, c�i a � :% 3/4"TO I V2 �....... EL��•z IN, ,, w W 0'EL WASHED .�r � � �: STONE Noa/� o. •'. . �o' OIA. i PROFILE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE P,9G �G�Ed0G 0mARIF, SOIL LOG WITNESSED BY: F�a Z3/9Bi 9 ao !� 'G. .c M�2.es DATE .. . .•. .,. . ..... TIME.. .'.. .. .. .. BOARD OF HEALTH TEST HOLE 1 TEST HOLE 2 T�ti4S E /L�LG P;Gr; 7 �o o9 ENGINEER ELEV.. .G 6/7, A4 ,e,1_5. s��•s % s 8 DESIGN DATA : NUMBER OF BEDROOMS 3. . . . . . . TOTAL ESTIMATED FLOW 33o GALLONS/DAY BOTTOM LEACHING AREA ?Bt 30. .SO.FT./PIT SIDE LEACHING AREA . . ./88:�? ". . SO,F'T./PIT -- /08" loB" GARBAGE DISPOSAL NoNG-' (SO% AREA INCREASE) TOTAL LEACH 1 N G AREA .Z 7°n. so.FT, S ¢ D SA+v D C'krv�rL PERCOLATION RATE Liss 77/ a MIN/INCH m. LEACHING AREA PER PERCOLATION RATE'..4Z.. SQ.FT. N.D. .WATER ENCOUNTERED NUMBER OF LEACHING PITS 1.P�?- WI W.JWo APPROVED . .. . . . . . . . . . . LARD OF HEALTH .°•'cS7a,--'-uv AZG SiDC---S = IS74I V:5 1 of DATE. . . : . . . THOMAS E.KELLEY CO. AGENT OR INSPECTOR ENGINEERS—SURVEYOR 346 LONG POND DRIVE TH YARMOUTH,MASS ��'(N OF02664 LLEY ELLEY n" o No.24Y60 40 y n/O NC B c o.25100Q. 1L8�7-,�c�D?Z7�/ �7c!vS�•- �e '� ISTE cG1STS' afl` Oc�ss ®��l► PETITIONER : W ,yS,ANN�sv/fc�zT SASS : �F�D su;ll� ONALL