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Home My WebLink About0414 PHINNEY'S LANE - Health (3) C)o 1 � - N SMEA KEEPING YOU ORGANIZED No.10334 2453L MADE IN USA GET ORCOND AT SMF.AD.CQM i - "4f50t a50 ^ /as--00 LOCATION SEWAGE FERMIJ NO. VILLAGE Cevl4c w `(le- �` INSTA LLER'S NAME ADDRESS J s r sco so S U I L D E R OR OWNER t.V'l DATE PERMIT ISSUED D D A T E C O M P L I A N C E . I S S U E D ^ s J r4X\ . o v e No.......s............ Fims..... ®...�. THE COMMONWEALTH OF MASSACHUSETTS �- BOARD F HE L/TH OC�c�s7.............OF.... .. .... . l.S . ?..... ................................. AVVIiration for Diapniittt Works Towitnutinit famit Application is hereby made for a Permit to Construct '(4,<or Repair ( ) an Individual Sewage Disposal Sy at 1 . 4'.._....... ..7..........o1.if.?t.?.�... ? ........fit.,....... /� Locq,tion-Addy o Lot......�_ e�. l L '� `� � ........... . .2..a...�I c.f,.�,!'_�."I:er l�l...(.�........--••--•---- ner Address W �M �. �'I_. CQ... .................... . ...................... �.. ......_... a Installer Address Type of Building Size Lot<aP- �Z�--Sq. feet UDwelling—No. of Bedrooms.._.....�..............................Expansion Attic � Garbage Grinder 04 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures -------------------------------- - w Design Flow..........75 ....................gallons per person per day. Total daily flow__._........ _.�5 ..................gallons. WSeptic Tank—Liquid capacity,�OQC�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..................sq. ft. Z Other Distribution box ( ) Dosing tank '-' Percolation Test Results Performed b G:--- ._!_Ql.- _e_. P a Y irZe�Cc. ate--•----- S.._. Test Pit No. 1 55�_.minutes per inch Depth of 'Pest Pit---- -,-q--------- Depth ground water...... 44 Test Pit No. �bA.......minutes per inch Depth of Test Pit... vim .. Depth to ground water._._ Q�-----. W .............. 56/ Description of Soil ./r cC�?t. �C _----.....I---- -•-•--------------------------------------------•------• x , t - ------------------- ------- - 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 TITLE 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Com liance has bee ssued by the board of health. 14F5 Signed---- -- ........ :........................ *� ------�----------- Date Application Approved BY------------- .... •-•----•--- ...------..._..._.... Date Application Disapproved for the f l owing reasons:................................................................................................................ .........................•-•-•---•----.....--•--•-•--------------•---•---.....---•------•--•---••----•--------------•.........._....------------•---------•••--•-••-••-•----••--•---•---•-••-•-••-••---- Date PermitNo........................................................ Issued........................................................ 4 Date .......................................... No....................... Fic3s................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE; LT ............OF.. ........ .............................. Appliration for Bhipasal Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct ( or Repair an Individual Sewage Disposal S t t. 7 6f/7 AA ............... .................... ..C_�:V .... ..A . ........... .. ................ ....... Loca,tion-Addcs ..... --------- .....5 0.... ........................ er Address .............U rn ............................... .........................................C..................................................... I.staller Address — _r Type of Building Size Lot,;Z.' 7�'y ---- ..Sq. feet U nj� --- ------- Dwelling—No. of Bedrooms.......... ..............................Expansion Attic (rlo Garbage Grinder P4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Other fixtgpes ........................................................................................................ ................*------* W. Design Flow...........�S ........................gallons per person per day. Total daily flow........................Q......._..........gallons. 04 Septic Tank—Liquid*capacity 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 Percolation Test Results Performed by._ t�.... _j�!... Test Pit No. I i�esi Pit._._ ....... Depth-tdground water_._._..__...._..minutes per inch Depth of ' t P, C .. .45 . �. Test Pit No. 2.V�,�-A.:�n..niinutes per inch Depth of Test Pit..._ ....... Depth to ground water..... :...... ------------ 0 Description of Soil....._ — Z Z.....7.............7 r.... ------------------------------------*....... ----------------------------"...... ------------------- Z.�..............iaa........................................................................................................ ................ ........... ........................................................................................................................................................................... U Nature�of Repairs or Alterations—Answer when applicable ....................................................................................... ...............................................................................................................................I........................................................................ 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 undersigned further agrees not to place the system in operation until a Certificate of Com liance has b ssued b the board of health.lia VA ,Signed.. ...... ......................................... .-d; .............. Date ApplicationApproved By.............. 1W ........... ....................... ........................................ Date Application Disapproved for the f I wing reasons:.......................................................................................................... ........................................................................................................................................................................................................ Date PermitNo....................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......106. eo.. ).. ...........OF.... ......................... (Irrfifiratr of Tompliana TLCU IS TO CERZIFY, That #ie Individual Sewage Disposal System constructed or Repaired by.......J. e .....Llnt��.aa................................ ......................................................................................... 'P at...... ............ U---------------------- . ..........U'"A..................................................................... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the "app lication for Disposal Works Construction Permit No......................................... dated---...........,_..............__................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON RUED AS A GUARANTEE THAT THE RUED AS A GUARANTEE THAT SYSTEM WILL FUNCTION SATISFACTORY. DATE:,-- ------- .................................. Inspector....---.— . ..... .................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAL . ........... 40a. .................. No...1.T>..- OF.......... Frs.... Disposal Work bToni ixurtiotv' r"mit Permission is hereby granted..... a tC ................................................................... -------------------------------- to Constr &,.%or Repair an Indivi�ual Se Diispq sal System yage V 4 atNo..... .. n .................................................... ree as shown,on the application for Disposal Works ConstructionPermit No.A?A!�.0_9 bated...__17.16.-.2s.......... ........... ................. 11 -b-B 6 R34e ..............._7............... 'DATE 4- z(, -?5 ..................................... ...................................... 'FORM 1255 A. M. SULKIN, INC., BOSTON ,I �r v �`�� /4 c /2S' W/07_t-/ I; s 3 u/ iv/io c' g.s' r3/► cks lb�� s s c�•vr o. 107 raL, F 1, r., LOT- V 1k40 4` rY t \\\ c1 V 14,49 , f� l { C 22 r �r r qY, 4i #(f ±tire ° -7(1,5 T 'r' r ✓pl fCJ J �` I �p hog° � �, 'Pi(` 'fr C Co ` O j C 5 �p�G�7Gr► : I EXISTING SPOT ELEVATION..' 0jj0 CERTIFIED PLOT` PLAN r ,EXISTING CONTOUR --- 0 ---- '� f-INjSNED SPOT: ELEVATI ON L � r 37 PN/w•vEy s G�N } 'INISHE®Y C®NTOUlt r µ°® NGfE ;'he it"ocat`aon o£ .an existin under t;:ound 'sewc:ra e d IN A ��tells, :or other44ut1.litles�;shown on''tr,is plan, is .approx �„cs� tiimat®;only asdetermined}from re coy dsk an verbal - SA ��, �, ��' information;';The=.cont.ract�o : isresponsible. for the �� RFv,seaPT 12 � bri`f catron of .t a ,existing. locations in" the field: SCALE+ � '�/D DATE � C`2- .:-c�R�Fa✓etrY��e.. R�®GE' E'AI�I�IEERONt3:Ca'IN CLIENT 1 CERTIFY THAT THE PROPOSED J E01$T:EHI: REBISTEREO �F JOB'NO. 930 / BUILDING SHOWN ON THIS PL AN h � : �x �"��k ;CIV1L °I:d4N® ` �` ,�J, CONFORMS TO THE ZONIN LAWS t AR 8Y+ ...� OP B RNSTABLE , MASSA� .71�'sMA1 N;S' l4EET ` CN EYE-, R•.a. 9 J♦ 8 t , ,NYAWN 5� . + 9HEETOf D E REG. LAND SURVEYOR ' ZpFr i�R/N. NOTE !F THE SEPT/0 TANK /3 MoRje THAN /2 INCHES BE401A/ GRADE, A 24 '- /O-FT, Ml�/• -LoVCH D/A1'7ET�i? GONC/?E TE CORER SHAL L 4»PYC. P/PE BLS 6ROVC,HT To �R'AOE <'E1N FXTRA HEAYY cox'ZRFrE 14JN. P/TCH CAST /RoN COVER-5,14ALL Be USED /F IAV �� 2,a CQyERS "PER FT.. OR/YC` AY �c (--X FLO wD/FFUSO R O O K s T•j• f Z GRAVE E0U1YALEN7,GALGEiP%ES TO �E �•UN/VECTEO •SER/E-TA T EiYO �' • � L/QU/O L2'f/EL �-- CL.EAN SA N O a: F ;:., ,SCNEDUGE 40 c3 o— li a•+% P.V.C. PIPE o y O Q C= I n1C� ��.; OISGHAAGE L/NE { sZ M/1V.P/TC D/ST, ti:' ,;�• =Y3;;- _ ••.,, :�`;•y;��'a 3 vs I SEPTIC TANK 80X p : h..PFR FT - i4q /=r'LEAC14fHG GALLS&Y 8 ;VASHED STONE M/+X:PAR *G L A SECTION OF GRav�rD fVATCRTRBLE ELE1/ 3 Z� G_P.o. ( soTroM: /SG x /,o = lS6 ipo SE;VA6E DISPOSAL SY57"EM �_ 7.4BULAT/O/� y.�Rw,o 7-aTRL CAn.4u7-y 3 9 6 �,�D, x D//r9ENSlOJ�I Q -z IrT Cc 32.a .5C.4LE : '/4. /' Q•' D/ME/YSlOI_Y B q FT, D/�.tE�S/oN C .Z$ FT / 4 / Solt T� s� 3 sr = s / So /1- [ OG OA7E OF S0/L TEST 4/ RL-SUL.TS f'f'/T/YESSED .BYP/;7 Con/L"N •SO/L TESe EZE✓. 38./ ELEV. - R�RCOL+4T/DN RATS .�f LC-SS M/K�IMGK ` � - PERCY�LAT/GJY Rf�TE fJZ TARN M/N.�/NCs! - / z o 1 z, �► Los!�'► cLFanr _ DESIC C�/TER/A N- TA nro .� � � .- /�luM•SER OF BE®ROOM. •' /v --'�Z 2°'L.s YER SA l + ; o ,"-•; » .. GA/?G�4QE 0/SOOSAG vN/7 n�o E y�J ti y �Oi 3 / ~S►b� � c� c� :1 i A�NF//gg7S7olvE EST/hjA7F0 FCori/ 330 GAL 44?'� jttAe/ylr+a5 ::3.:.tom.•:._:=.•:.:<i•_ • ?� S/OELEACH/N4 AREA SQ.f7, 6orno,#4.LEACHING A RFA SSJ.FT. "--iL SE Cl - ON .x-X 7'0 TA L AREA 2-5 Z SQ FT ►A E E R Am EA - » FSRRV . A 4 SCALE. 14 O Q MO GROVArp WATER ENCOVH7 ERED r� INVERT�LEY.4T/ON.� jt �'ROONP x/�tTER AT EA Ey -30.6 �\ LOT 3-7 .pH/NNEySL�NG- i /NYERT AT $U/LD/IVG 39 - FT. 'dr //yCETSEpT/C TANK ul FT 1 , � A. .ALBER ELiR..'O E )"1 MORSE OUTLET.SFP7rC 7A' A(N t Na.59367 p No.10951�O 2 JIVI-07 D/ST��'�®uT..�oiv.eox 3�6 � E4D)?BL3t�E�iilG/JdEER/14�G CA,IIttC. t erSZ[R�°��" \�'o�`G i s r` v��` o aTL7 7'OLs7X►'tvtl:T/oiv[�c3�c 3 8.4 p - ?!2 L�??.d4!/t/ST., ND`A/4f'/1l/T.MASS. v/ - J3 t l rc��9 Fssro , EN /15/LL7`FLO/�fJ'01FFlJ.5 3g �-Fr . Cl ;e�,��,e��,e &A7°t M • -ted by HIGH GROUND) WATER I_LVLL" COMPUiAtIOW S i t e L oc a t.i on:. N// �,c�i� Lot N o j Owner: Addre"ss: Contractor: -- ----- Address: Notes: STEP 1 Measure depth to water table 1 to nearest' 1/10 ft. J M� - - - - - . . . . . . . - -- date -- - STEP 2 Using. Water-Level Range Zone and Index Well Map locate site and determine: A) Appropriate index well . . . B) , Water-level range zone r3 STEP, .` 3 Using monthly report"Current Water Resources Conditions" - s determine current depth to Z4--2 water. level for index well . . 5/gS mo yr 'STEP 4 Using. Table of Water-level Adjustments for index well STEP .2A current d&pth to water level for index well (STEP 3) , and water-level - — zone (STEP 2B): determine 444 water-level adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I---� STEP 5 Estinate depth to high water by subtracting the water- level adjustment (STEP 4) _from measured. depth to water 2 level at site (STEP 1) --- }