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HomeMy WebLinkAbout0046 QUISSET ROAD - Health 46`Quissett Road S Centerville ` A= 250 - t29 i _J No. 4214113 ORA ESSELTE 10% O O O O NO.U.- .00 Fss. .................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ���P3'n..... .....0F....... /�17._It!?.X/......................................... Appliration for Uiopoii al Works Tonotrnrtion lirrutit Application is hereby made for a Permit to Construct (.<or Repair ( ) an Individual Sewage Disposal System at: . Location Addre ) �1 or Lot No, Owner ,�j / �/ Address ,Wa •..............%Y-(G!`�S ._ �°1 .�r�l��_.l®e7...�'��..._ ...........,F Y`J-�-'2-ww , efd-4; S=............................... Installer Address Type of Building Size Lot..ZOa.!?�®45-----Sq. feet Dwelling—No. of Bedrooms................- -......................Expansion Attic ( ) Garbage Grinder ( ) �P4 Other—Type e of Building ..... No. of persons............................ Showers YP g ----------------------- P ( ) — Cafeteria ( ) Otherfixtures ------•---•--------------•-----•-----------------------------------•----•-------------------.----------...------------------ W Design Flow.....................` .................gallons per person per da . Total daily flow.................. r©...........•..gallons. WSeptic Tank—Liquid'capacityAAA45 gallons Length..... ...._Width................ Diameter................ Depth................ Disposal Trench—No. .................... Width.................... Total Length.;.................. Total leaching area....................sq. ft. x ;,F Seepage P f No........./.......... Diameter.._ ®.`=. ... Depth below inlet...:._-`--�_-,?."Total leaching area."W' . ..63sq. ft. •,,. z Other Distribution box ( � Dosing tank ( ) Percolation.Test Results r Performed by..tgr-4� ..Wjv. 0A?4Z60Test Pit No. 1-----�_2-..minutes per inch Depth of Test Pit------/.A..._..... Depth to ground water....A--- .... Lt,p/f¢:E6z�Test Pit No. 2.....G.z-_minutes per inch Depth of Test Pit....../--'4....... Depth to ground water..../.Vkq.w-.t . --•---••---- ••-•---------•-•-------- ------••---- -- -••-----••-............-•-•••••-_---•-••-•••-•.............----•---•....._......••..........---- T � ; � !escripton o Soil....e 4-Z:41 .. � ---- 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 TIT f,,-. 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 of health. /Si,gn ......•-••.....•----•-••-•-•----•.............•-=•-•-••-•-•-••••---•...••-••......•...Application Approved BY ---------------------•-••---------•----=-----•---•--•--•-----...----•- ..DateApplication Disapproved or tg reasons--------------------------------------------------------------------------------•-----------------------.••-•--- --.......-•------------------------•-----..._•---•••-------•--•......--•-•••-•----•-......-•--••••-••••----••-•--•...---•--•----••••---------------•--•------------•-----•------•-------------------•--- Date PermitNo......................................................... Issued-....................................................... Date ' - Fps.............................. a THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........./.rh... �..'I..............OF....... .r�? ....................... ............................................. Applira#ion for B44posFal Works Tonstrurtiun ramit Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal System at: C` 1. e)e:74'/ Ile- 14,35,/n-1; - J ------------ . .. ......................................................................... ..................................................._........................i..r.i..A...l............... Location-Address ) , or Lot No. ... ✓L /rca s r� �.Lc-lac l .! s�l//'�z .-7�.._.�f -�� :: .._... ?`_�_Urr :n�.:_.IJc;1 - ••- ..............•----• --..........- ---•-- '.. - owner / / Address r W 'T� I{`C'fff1d7 !- fi /,/I�''e ,7,1� i 9//_t•�y . ,-� --•-........--'-- ••.............»-•-•----•--•...._....._.........---•-.._....::.....-- ---•-•-•---•..-• -••---•-••----•-••-•---.._........._..._..•-----........................-----•-- Installer Address dType of Building Size Lot._%�:.:Z-'..-`5.....Sq. feet V Dwelling—No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—Type T e of Building No. of persons.............•.............. Showers W yP g ---•--•--------------•------ P ( ) — Cafeteria ( ) a Other fixtures .------••-••-••-••--••••--•••••• . . W Design Flow............... ....................... per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacityZAY—%.gallons Length___-_ -/2 Width................ Diameter................ Depth................ W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........./---------- Diameter-__ Depth below inlet...... Total leaching area--'>`�_r_lsq. ft. Z Other Distribution box Dosing tank ( ) 04 Percolation Test Results Performed !?Jbate....�/_V:................. I'd /<?'/4z(')Test Pit No. I.....'._=....minutes per inch Depth of Test Pit------ ._....... Depth to ground water.._A6��n;'....... LT4PI,74z(z)Test Pit No. 2....:�.. --...minutes per inch Depth of Test Pit...... z......... Depth to ground water...f�/'? D Description of Soil...F �4 : � �, ./- `...............................................' ' - /.. ` ............................. .-. x ................. /l -�c_i e-.)-4....! DJ� Lif7'�/!! 2 �� ` ' �,� �r. /r,' �1/l '. .. ..e...... V ....................... ......._... .............. .............................. ....... ..._ _..�._....._....... 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 I iT I of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliansp has been issued by the board of health. igrie •••--••.....................•-••----•----•---•--•-•--•-•-•-•-•.......---...........-- ......... Application _ .� Applicataon Approved By................. ...... ....---...------•-------.....----•--._......._..._..-•-•-•-•--•-•-•--- ................�' ------------------ Date Application Disapproved Ifr following reasons:-••---•-----•-•••••••--••--•••--•---------------••---------••-•••-••--••----•--••-•-•-•-••• ••---...---•-•---- ••-•.....•-••-••..............•--•-•-••-••-•-•••••-•-•-••-•-••••-••--••--....--••--•-•._.......•••------------•---•-•-----•-----•---------............................................................. Date PermitNo...............................................---------- Issued.................................--.................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...............................OF..................................................................................... `r Trrfifirair of Tompfiana THIS lS O CERTIFY, That the Individual Sew Lye Disposal System constructed ( "or Repaired ( ) by . .................• ......... ... ...... } ------------.........------•---------------------------...----------............-•---.........•-- ,� - i tatter at .............- - ------- -------- --------- -- has been inst. ed in accordance with the provisions of TI`j j e State Sanitary Code d i d in the application for Disposal Works Construction Permit No.................. .................. dated_._.. .... :........ ............... THE ISSU CEO THIS CERTIFICATE SHALL NOT BE CONSTRU S A GUARANTEE THAT THE SYSTEM 1lll PUN N SATISFACTORY. DATE.--- -- 1.2Y.. .p.............................•---•-•--.._.... Inspector..-•--- --• -•-•---•--•-•-•---•-----••••....--............. .................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF..................................................................................... �/. No.... .J.....::7..... FEE.»..'............---••- h � n� �.� �nn��ruan rrmii Permissionis by granted............. - �... . -----•----------------------------__._..---------------------------.........-----------................. to Construct r R p 'r an Ind' Id gage Disposal System atNo....... .. ... •• •• •---- •---•-------•-......--------•--. ------------------------------ -----------�................. Street ����q� i as shown on the ap licat' for Disposal Works Construction Permit No._�............... Dated.. _......_._.._.._................0...... DATE-- .......................•.................... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS SITE PLAN T YPICAL PROFIL E SCALE — / _ F t r . :. NOT TO SCA L E /B"STD. LT WGT C.I. MH COVER 4"C.I. PIPE 4"B/r FIBER PIPE TIGHT ✓O/NTS OUTLET LEVEL F7T-I L OW L!NE TO FIRST ✓O/N� — - - -- DWELLING 3`� i C.I. TEE C.I. TEE rr t �, tol �1 I 1-- ---- STANDARD PRECAST �— I ! CONCRETE>�'' 'GALLON I O O L.--- - - � SEPTIC TANK LEVEL , STABLE BASE. T � ^, SEPTIC TANK TO BE INSTALLED ON LEVEL , STABLE BASE { p EL wr \ 2 — !/e TO 1,12" WASHED PEA 5TONE _ LEACHING PIT ALL AROUND FREE OF !BONS, FINES BASE TO BE LEVEL AND DUST IN PLACE BRICKS MORTAR COURES 3/4" TO I-I/2" WASHED CRUSHED *7 AS REOUIREO TO BRING STONE ALL AROUND FREE OF -� - COVER TO GRADE 24 C. I. MH COVER IRONS, F/NES AND DUST IN PLACE AND FRA ME P , ttl --t- - - - {4 -_ .Y._._ �\ i 4 T ^e' FLOW LINE __AV_ - A LEACHING PIT SEC TION— INLET-- _ qp PIPE � I. CONCRETE TO BE 4000 PSI 28 DAYS 2. REINFORCED WITH 6" x 6" NO. 6 GA. W.W.M T 3. 2' AND 4` SECTIONS ARE AVAILABLE FOR GREATER A r;zvF'• 1 D�3T 2L >; V.,K ,d ' DEPTH REQUIREMENTS. 5 T I>, r-x I*;:.A - pvIQ4 . PI�ja2(� j:;,jAtK L � OPEN/NC WlTH 4-l/8" 4 NUMBER OF PITS REQUIRED LeAG 3G 'SIt�1 Y; , I OUTER DIAMETER 8 NOTE: EXCAVATE TO ELEVATION OR LOWER AS /-3/4` INS/DE DIAMETER 3" REQUIRED TO REMOVE ALL LOAM AND CLAY BENEATH ,�y PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN � f GRAVEL TO DESIGNED GRADE -T 4 O 6' - 6" - -i ?� 5` - I- --- --- - i-- - � j'. EFFECTIVE DIAMETER I ! (NOT TO-EXCEED 3 TIMES EFFECTIVE DEPTH) ✓� -.°- __ -__ ,C ___ ,,��, WATER TABLE a _.----" kJ U rJ PCs fc Q 6,0 U hJ 7 CF: M r. —' 21 '. c SOIL AND F'ERC. DATA ----- GENERAL NO TES PERC. RATE MIN. /IN . NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. SEPTIC TANK, DISTRIBUTION BOX , LEACHING PITS TO BE STANDARD TT BY: 19 v - W r--_ c r (wM. wuA Q%AdIC14. � A-i9416. + ►rc. •� ES -- PRECAST REINFORCED CONCRETE UNITS. Lj A `( .; v r� -1 A 4- v s� � . �� . I-+ . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE t ,,l„_� WITNESSED BY: ____--_ _ ____�_�__ i r-7 L' I 'cl- ';;�� TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE , TEST PIT GR EL.: ' DATE 7 '' ' `' ' ' � MINIMUM REQUIREMENTS FOR THE SUBSUFACE DISPOSAL OF TEST PIT NO. I TEST PIT NO. 2 SANITARY SEWAGE EFFECTIVE I JULY 1977. O 0" — ------ , ANY CHANGES TO THIS PLAN MUST BE APPROVED B( 7HE x - --------- BOARD OF HEALTH. 5Lie-po _ i ` AT COMPLETION OF CONSTRUCTION , PRIOR TO BACKFILLING, THE � i A.•1 �D, '� .�. �} is JD W r4_A -JFEL BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. M *G PITCH ALL SEWER LINES 1/4" ; FT. UNLESS INDICATED IT OTHERWISE. c t % 4,7 .tu. N aT rt7- DESIGN DA TA BEDROOMS __— DISPOSAL 1) 1 EST TOTAL DAILY EFF. s) 3__GALS. L EGEND — SEPTIC TANK- °v y GAL SIDEWALL AREA _._2 GAL./SO. FT BOTTOM AREA —_!' --GAL /SQ. FT SEWAGE DISPOSAL SYSTEM O xo0 EXISTING GRADE LEACHING REQUIRED-,°�_'_�_-."'� SQ.FT ZtJNE_ ._ " _" ___. 0 00� FINISHED v'RADE ACT,_,AL LEACHING AREA Zn<j %' SO FT. fOR O . QO INVERTELEVATION DOMESTI:l WATER SOURCE. __ - --_---- -- +. ----- -- P R 0 P E R T r L I N E 4 __.-- V� H " f, q G v �1 "L. 6- �c r )T = w t PLAN REFERENCE .._ - - __ : `i' SCALE: AS INDICATED DATE MEAN H;GH WAFER 4 — — BENCH MARK DATUM F tx v �, L„ r `� ' y -y-' AL- .it- MARSH WM. M. WARWICK 0 ASSOCIATES BOX 80/ - NORTH FAL.MOUTH !_ ao t? 7_ J ' .i IU © IU • 1-t A. z-� �- 17 cr. " bf1554 CRUSE TT- 0255E