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Home My WebLink About0060 ROLLING HITCH ROAD - Health 6U Rolling Hitch Road Centerville A= 192 - 081 P OPendaffor ofsse/te 4210113 ORA 10%@ P4 ._..V..__ t ASS .S OR'S N0. PARCEL - CT� O IC-Aj ION c SEWAGE PERMIT NO. VILLAGE I N S T A LLER'S NAME a ADDRESS y S UILDE R ' OR OJN NEIt DATE PEERMIT ISSUEDJf DAT E COMPLIANCE ISSUED _ � _ 2 Al 1..3 0� ASSMSORS]GIP NO: . .e�..- PARCEL NO.. Fps.. ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �d--INy. .......--OF..._ �T/...-z3�� 'J App iration for Diipnial Workri Tonstrnr#iun ramit Application is hereby made for a Permit to Construct (✓j or Repair ( ) an Individual Sewage Disposal System at: ................................•--•--•---••---......--•'•-......• ••'......--•-----•-._.......-•-'••--------"".............-----'•'-"-'-..._..........--•--•••••. Location-Address It / ,/� ..........--•---........................• --------.............._........................--•'-- Owner Address Installer Address lSaa q- Q Type of Building Size Lot____________________________S feet Dwelling—No. of Bedrooms.............¢..........__.....____.__.Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) aOther fixtures ..-------•-•---•-----------------•-•--••----•---•----•--•------•-•-•-•...•--•---------------•-------••----••-------------...................--------- d W Design Flow............... .................... per person per day. Total dail flow.......... `'_.__.___.._...._.....gallons. R; Septic Tank—Liquid capacityl'oo gallons Length._'6.�6...... Width._4.��..._ Diameter................ Depth..'s"..'_- I� W x Disposal Trench—No..................... Width.................... Total Length_._____.......__.. Total leaching area....................sq. ft. Seepage Pit No......_y.__..__.. Diameter........ �_.__. Depth below inlet--------iL....... Total leaching area.. ¢...sq. ft. Other Distribution box ( ) Dosing tank ( ) z Percolation Test Results Performed by.... lC�zC� Date.__. y._.__z� f9B� a Test Pit No. l.._4-..7....minutes per inch Depth of Test Pit.... _.. Depth to ground water......_.'-'----------- . Test Pit No. 2.__G ....minutes per inch Depth of Test Pit____! ...... Depth to ground water------- ................ O Description of Soil-----e, 24aI-VO&OC&/+--1 �svg- S--� Z � -•--.......-•-•--... - , . "►�'' S/'YJ�la p� �'/Z ............ -••-•--- .....�-� s !> ----•--------•-•----•--•-•••••-------•--•-•--••..................... V -•-•---••------------•----- ..................................................................--•-•-••-------------------.._..---------------------•-------•-•---•--•--•.....-----••-------------...... 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 TITLE 5 of the State Sanitary Code— The undersigned f 4-arees not to place the system in operation until a Certificate of Compliance has been ' by t b alth. Sied. .•-. -• . ---•--•---- ....._. . .. .....-•- -------------- --------•--••----------•-------- Da Application Approved By.............. ... . . . .... •-• •----............................-•-------• Date Application Disapproved for the following reasons:...................................................................................... .T ...............•-•--•-••-----••-•••----•••---•--•--••--------••-•--------------••--•------•-•------••--...-------------------•------------------•-••-•-----•----------•-•-----------------------......... -i y / Date PermitNo............. -C ................... Issued....................................................... Date t �T NG_ •A•-•.....--••• i FEs.....� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......................•••.......... A�p iraatiou for Diipa�oaal orkii C omitrurtiou amit Application is hereby made for a Permit to Construct (--I or Repair ( ) an Individual Sewage Disposal System at: .. .... ...._ .......... .. --•--------•-•...-•-••-•-•-•--..----• -•-•••••-----•••--••------••............. -----------------------•-•-------......•. _ Location-Address Owner Address ....!�....iT/�'T 1 E�' / �7i`^1/�raj l G7 ............ Installer Address Type of Building Size Lot...Z .......Sq. feet U Dwelling—No. of Bedrooms............. ..........................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers = Cafeteria 04 Other fixtures -------••---•-- ----------••.. . --•--- d W Design Flow................. .............�-.............._._...___..gallons per person per day. Total daily flow.........'Cl "...........•..........gallons. WSeptic Tank—Liquid capacity! '6-...gallons Length.&.'&.•..... Width.�......... Diameter---------------- Depth_�_�`�_... x Disposal Trench—No- -------------------- Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........ Diameter.......f`�_....... Depth below inlet........ ....... Total leaching area.. �----sq. ft. Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by.... _F'W,1'�; ._.__. :.. C« Date_..�? .....� ............ � � ,. �- ,r ,aa Test Pit No. 1---�..z.....minutes per inch Depth of Test Pit___j ` _.____. Depth to ground water.._._.-.. ............ Test Pit No. 2...!_.T__....minutes per inch Depth of Test Pit---- u. Depth to ground water......"".............. ..----------•------l--•t-• ••---•l-•r----/-a----- ----•••-----------•--••-----e--•-C•--•-••-.._....-•.--"---•..-...`..�...-.-�-----�-"-!�••-----•--•S-•---•-••-•-•-••........-•--- O Description of Soll----- {-.--.----- . v �.. C------------------------ ....------••...0 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 TITLE 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. Signed................•-- ••-•--•.._....--•---•----•-------•---------------...--•-•-•---•- ................................ Dat Application Approved By. ( ..a.... > � ► Date Application Disapproved for the following reasons--------------------------------------------------------------------------------------------------------------•-- ..........................•-•---------......------------------•-••--------•-------------------------•------------------------------------------------------------------................................ Date PermitNo.-•-•-.......'•...... -� ...................._ Issued------------------------------------------------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ ..U..... ...............OF..................................................................................... Trrtifiraatr of Toutphaaatrr THIS IS LTO,C, RTIFY, That the Individual Sewage Disposal System constructed (r. y or Repairedby--------------_---- .. Installer _,.. has b en installed in accordance wl the provisions of TITLE 5 of The State Sanitary Code-as described in the application for Disposal Works Construction Permit No:.� -------- J....... dated-..... �_ _ I� ............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................... •-•' � �...............................• Inspector---- -- -- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH /'� �''�+ i.c. ..........OF......... �' !i^/S :'� r N •• _?••••L-��r FEE.. .......... Disposal Vor 15 Tonotrurtion Permit Permission is hereby granted : ". ., s- •- ...... ------- to Construct (w-) or Repair ( )y an Individual Set& - isposal System street as shown on the application for Disposal Works Construction Permit N ._t .�..__!Dated....../ __2. _A ..... Board of Health DATE............................................................................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS ti . mp or- /G�i2� ell l(ol pi IZ' �ti Ems.•_ � G/c3 ti. Lb7- is- Box ———-� LS.i O �d O T�'NK N Z/ W 1 �O/ *'/4 �, I elo / 0lcl 320 a '07- eti' 1 c'qrao4 -s'/Tom. Re,gw LOCATION '`!s??9!.3« `Crib??-✓!u.�, SCALE . . �30.�. .... DATE M:9y Z3 �SB� PLAN REFERENCE t3E7n/C „l-oT �/ Wv. , r-.,!�/ /�L/a?v joo/G Z36 ��Ptt Mt�k �a�CE. .�? . .. ... . . .. . . . . . . . . . .. .. . EDWAPID LEY . .. . . . . . . .. .. . . . . . . . . . . . . . . . . . . . . . 0. 26100 #� a. ;� °fG1gTEn`c 1 CERTIFY THAT THE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND LLP,') .. AS SHOWN HEREON; I DATE REGISTERED LAND SURVEYOR N. .SyE7- L c� L SNT"s L. . .G/, So. . . ... . TOP OF FOUNDATION a„ CONCRETE COVER CONCRETE COVERS Z"qj 'e o 4, AS IRON 121 . OR SCHEDULE 40 12 MAX.P.V.C. PIPE 4"SCHEDULE 40 PVC.(ONLY) ° PITCH I/4"PER.FT PIPE- MIN. LEACH PITCH 1/4 PER.FT. PIT PRECAST a LEACHING o;o �INV c� PIT OR EL.... . INVERT INVERT o . ;:� ° SEPTIC TANK S8 DIST. 4 ! • w EQUIV. o INVERT EL.. ; . ��. . BOX EL...7..... ' >s ,yam /Sc'- GAL. INVERT G� ~~ �; ° EL.....ram.. INVERT '• v°' 0: :;�: 3/4��T0 I I/2� EL?8.o7 w4J WASHED w STONE 6'DIA. DIA. PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE SOIL LOG WITNESSED BY : DATE .!`?A,Y.L2 /9V TIME.1P '444-' !! !> /�-1c.�C 1w BOARD OF HEALTH TEST HOLE I TEST HOLE 2 . /. . ENGINEER woo;p(�A r) Woop r lop7 24-' s0a_so,c. 24 So,` DESIGN DATA 'Z.s7 6o —&z. s7,7o co'q str di>pazz r NUMBER OF BEDROOMS So4wo S9 le TOTAL ESTIMATED FLOW . . • . , . GALLONS/DAY e4- CRsYv� a4 C�AVE�• BOTTOM LEACHING AREA SO.FT../PIT/,-A D. "Z,Sz'4a •S2'70 SIDE LEACHING AREA . . . ��B�,ro SQ.FT./ PIT/47/.CR.P. CoE Cni3�st GARBAGE DISPOSAL yC . . .(50% AREA INCREASE) SgNo Sao TOTAL LEACHING AREA SQ.FT k�4� •�/7,Lo /44 E'Z, 47.7o PERCOLATION RATE ss. !/o MIN/INCH No WATER ENCOUNTERED LEACHING AREA PER PERCOLATION RATE SQ.FT. NUMBER OF LEACHING PITS . .n!Va. /n• w!n� APPROVED . . . . . . . . . . . BOARD OF HEALTH T �•F�'T��S7�/E�O.V /a2G S/DE3, DATE . . . . . . . . . . . . . . . . . . . . . . . . . AGENT OR INSPECTOR OF A OF o`er EW.Fit .a(lltl LLEY .0cla No. 26100 RF fcISTE, s CEW7 Zl//GG�' . . . . .. � �s�°`a< <A'DS SgNRRa�P� PETITIONER � T/ S742 ;V a ti i xu.V. mp of ,2¢ For Fell 4' Z Box -74 LT_ .4. lS O sepnc \ d oK Rom N Jo' 1 3 �� / a��► ell 7-Co-el P �CA� to'' LOCATIONrsrr?�3L ,`CE?vr�TLI/icGE� J' SCALE . . �/ I =30.. .... DATE .,...,,... .. /9BG PLAN REFERENCE \,,r of As E CEPSq / . . . . .. . . . . . . . . . .. .. . EDWA J,b ,N, LEY N . . . . . . .. .. . . . . . . .. . . . . . . . . . . . E v An J�Ao. 26100 0 I CERTIFY THAT THE ..... ... . .. . .. ....... .. . . . . SHOWN ON THIS PLAN IS LOCATED ON THE GROUND i. � w AS SHOWN HEREON; DATE . .. . . .... . . . .. . R6777-/4;>�e2z REGISTERED LAND'SURVEYOR 1 TOP OF FOUNDATION o„ CONCRETE COVER CONCRETE COVERS Z'� 'e; 4' CAST IRON 12"MAX. r OR SCHEDULE 40 � 12"MAX. 4"SCHEDULE 40 PVC.(ONLY) `p P.V.C. PIPE PIPE - MIN. LEACH PITCH 1/4'PER.FT PITCH I/4"PEL.FTff=n== PIT 1� PRECAST `—INVERT Q LEACHING '° EL•. s8.'L/•. INVERT INVERT o . e•:' PIT OR SEPTIC TANK DIST. EL.sB.iS .. EL:SZ??�. ' ; >s EQUIV. INVERT - Box o; EL. � .. �So•• •• GAL. INVERT INVERT �`, v° 0: :,►; 3/4°TO I I/2� � ELyB.o7 S d v u o �: o EL..7-..... WAS w STONE .; kii 147-IfZ PROFI LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE P- s 773 SOIL LOG WITNESSED BY : DATE .!`?'`�Y.L?i9 TIME.�O ' !!`/�`�!`n. c.'� �! BOARD OF HEALTH TEST HOLE .1 TEST HOLE 2 �`/ ENGINEER ELEV. .S`�•,G,". . . ELEV. .779' 70 . . 24 s�Q.so,� Z4 DESIGN DATA : -z..s7 c� s7,7o ¢ Coye-r Cagn.Sr NUMBER OF BEDROOMS SAWo SA�o TOTAL ESTIMATED FLOW . . 4 '�. . . . GALLONS/DAY BOTTOM LEACHING AREA . ?��? . . SQ.FT. /PIT/ , D, E2 Sz,Go �2 S2,7o CO SIDE LEACHING AREA . . ��'B!`SO /.C.PD. SQ.FT./ PIT47 Coih2dE Coi>�St GARBAGE DISPOSAL yC-S . . .(50% AREA INCREASE) Sgr/o S` d TOTAL LEACHING AREA SO.FT PERCOLATION RATE 7VAlV. 4 MIN/INCH &L, 47,7o LEACHING AREA PER PERCOLATION RATE .e�- d. SQ.FT. No WATER ENCOUNTERED NUMBER OF LEACHING PITS . .n!V0. A!III71. APPROVED . . . . . . . . . . . BOARD OF HEALTH DATE . . . . . . . . . . AGENT OR INSPECTOR N OF Afgs� H OF go EDWA`(" O ` �ON P �T !(IELLEY f no:5 /QOGL-IAIS 1117V l /eV*D i'o. 261G0 c� l E,p '¢F61ST ER�� S CIS V/GG6� PETITIONER