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HomeMy WebLinkAbout0021 SCOTTSDALE ROAD - Health 21 SCOTTSDALE ROAD Centerville A = 229 — 064 S M E A e Na 2t633M UPC IUM .ms"Mm • Mab In um "OCATION HSE02-1 SEWAGE PERMIT NO. VILLAGE INSTALLER'S NAME i ADDRESS , e UILDER OR OWNER DATE PERMIT ISSUED ED r DATE COMPLIANCE I S S U F#6° l=/�aAl �r 0 25o a�� o i 0oo 6A L- "�=t3ok Pas -CACT --*kvs i0oo &A i -FA NvC PRE-tRST WEP"t N(p Pct' t�° j'sa ;7_- � No......!..........3. Y . F$t3.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ ...........................--...OF.......................................------------..........••----....................... Allpliration for Biipnsal Warkii Tonotrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ()�) an Individual Sewage Disposal System at: .......91............n . T--.XVZE! F---•--•--------------------------Aa -----------------•----------------------- Location-Address or Lot No. ... ► ....s c�. 5................'----'--...........----- --.yoY . 2 ! ..sz..... r � vied ........... ---------- Owner Address a ---•'•-- •- .......--------=JX-�- �'-------------..-------.-----..----------------- ------------------------------------------- Installer Address dType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.....�.................. ..._......Expansion Attic ( ) Garbage Grinder (NO) `4 Other—Type T e of Building 49._...__.....p„� yp g ___./4 No. of persons.........2................ Showers Cafeteria ( ) GaOther fixtures ............................................................................. W Design Flow................110....................gallons per person per day. Total daily flow........... -20.....................gallons. WSeptic Tank—Liquid capacity j,P0L).gallons Length................ Width................ Diameter................ Depth................ x 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 by..... 4SW6--•-•-�--L_e_ 5 ...................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1:4 •-----------------------------------•-..................................................................................................................... 0 Description of Soil........................................................................................................................................................................ x V -•••-•--••-•--••-••-•-•••-•-•---•----•---•-•••••••--'••---•-•-•-----•--------•--•-----------------•-•"••--•-••••-•-•----•..._....•'•-•-'-•-----•-•--••----••-•-•---............--•--.................. --------------------------------------------------------------------------------------------------------•--......----------------------•----•-----------------------.....-•••-•.....................---- V Nature of Repairs or Alterations—Answer when applicable__owymm-----Ax/57/-A C4.../hv5.4.....m..71.0. ICI.... qAl.D!ttT1-® N..D_..ftA'I?1fa � ,• ® -------------------------------•-----------•--------------------'•-------'------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL% 5 of the State Sanitary Code—The undersigned furth to plat m in .operation until a Certificate of Compliance has been issued b the board of h th. igned.... = ---- • .......... Application Approved BY = ..... ....,2o tejo Date Application Disapprove or t following reasons:,............................................................................................................. ............•.................................. .......................................................... Date PermitNo.......................................................- Issued....................................................... Date No................_....... + FiQs.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................------.._.....OF...............---....................----------...... ApV ira#iou for 11ispniia1 Works Tnntrnrtinn rrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................_................................................................................ .......•••----••-•-................•--.....---•••..............•••--•-••--•••••••............-•--- Location-Address or Lot No. ......................_.......................................................................... ................................................................................................. W Owner Address --•------ ....... .... Installer Address Type of Building Size Lot............................Sq. feet �. Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ---------------------------------------•---•---------.....-----------------------------...-•••-•......•.........----•--•-•----.....---•-•....--•-- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length.............•.. Width................ Diameter---------------- Depth................ x 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' .... ---------------------------- -••-•-------------------- -•----------------------------------------- -------------------•----------••--------------- -••------ • 0 Description of Soil............................. W 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 the provisions of TITLE: 5 of the State Sanitary Code—The undersigned furtl ag>ee tfp1athe•-sy-st in peration until a Certificate of Compliance has been issued by the board of h alth. igned............................... .......•---• ........•----_._ .....--•-•-. Application Approved By- ----=---- -•--•----•-------------••-•-••-•-••---•----•-••...............-----•--•-•----•--•. ate,/ Date Application Disapprove f or t following reasons---------------------------------------------------------------------------------------------------------------- -------------•...............•----....._...•••. ------•---•---...-•----------•-•-•-•--•..........................................................................Date-----......... PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.................................:.....*"*****............ ...... (9-rdifirttte of Toutpliattrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Installer at..........................................................................................----------- has been installed in accordance with the provisions of TLTIE K le State Sanitary Code as described in the application for Disposal Works Construction Permit No. ..................................... da.ted-............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................................. L O....... Inspector.....---- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH '✓' ..................... ........ ......................OF...................... NO ......7�........ FEE. ?....:.............. rho nns#r wit ramit Permission is hereby granted.... ..`.. . .... ---..:.. ��___•..--•-------------------•--•---•........................ to ConstrtLp c,�r Rep it I e Disposal System atNo. .................... .... Street as shown on the application for Disposal Works Construction Permit No < ._..=.__..... Dated.......................................... .................... -- DATE................................................................................ Board of Health FORM 1255 A. M. SU.LKIN, INC., BOSTON 1 REVISIONS: TEST PIT DATA DATE CF TESTING PERC. TEST DATA : SEPTI C TANK DETAIL : sIzE- �_04 cam GAL. DIST. BOX DETAIL : LEACHING FACILITY DETAIL' NO. DATE TEST BY: - DATE OF TESTING. TANA, TO CONFORM TO TITLE 5 REOUIREMENTS. TO CONFORM TO TITLE 5 REOUIREMENTS / 4 64 .a ota GNRse'irs� r. P WITNESSED Br TEST BY NO. OF OUTLETS _ 5 ----------- - 4 17 84 - -- - --- - --- ------ --- - -- - - - ------ - -- -- - - -- - -- ----- - -- - BY, -- --- — � �I /27�'h _ E �4 ' £MOVEABLE COVER 3 _ S 9-Q4 MO tWITNESSED NHO BROUGHT TO ac, N~ho/n v�.t► Dcr:RF N�ot.! •.•. .. :. FINISH GRADE. °-- '. --•-- . .. • T AF -�LA4M AFILL /2"M/N. ..• ., R'AS O ------�------ - -- -- -- - - 3 CL EAR 3 CL EAR e r--- . =-i _ f- OUTLET PIPES • _ AS REOU/RED --- - ----- -- - • 6„MIN. 2"MIN 6"M/N I I DEPTH OF TEST SVIvI -- - -� --- -- - INLET- RA ► �� �� DIST. I� TE _�. MI/ll 1"(w 'ice_-- _ _-_ D /o"M/N ( r I --- -- ---- --- -- - -- — --- -- — --- C SEE 1�OT INLET T£E ---- • OUTLET TEE BOX L9 INLET AND OUTLET 4'0" MINIMUM OUTLET TEE DEPTH /000- GAL. I 24'r I 2' 6" SEPTIC TANK .� I • PRECAST OR BLOCK •�t TEES TO SE CAST L IOU/D DEPTH 14"AT L/OUID DEPTH OF 4' C SEEPAGE PIT F - - --- IRON, SCHED. 40 . l" CONCRETE > , -- } - - - -- - ---- -- -- -- --- - --- !4 5 --. b NSTRUCT! -r I DEPTH OF TEST ----- 24" �' p c av /0 — P.VC. OR CAST/N „ PLACE CONCRETE 29.' " 7' - MIN. 0. I , RATE' CONCRETE o_ 34 ' 8' BOTTOM ON LEVEL TABLE BASE IL41 �i -- -- - _ - - --- ---- - - -- CONSTRUCTION - IL I i (WATERTIGHT) INLET TEE PROVIDED WHERE SLOPE FOUNDATION u- I, • • , -':: ° °', CIE TANK TO BEABLE TO WITHSTAND OF INLET PIPE EXCEEDS 0.08 % OR ----------- IN A PUMPED SYSTEM. I BOTTOM OF TANK ON LEVEL STABLE BASE H-/0LOAD/NG UNLESSUNDER 20 M/N / `Wi4SHE0 STONE I --- -- -- -- - - -- - PAVEMENT OR/N DRIVE.H-20 I L OA D I NG UNDER PAVEMENT OR I DRIVE. i NOTES : PLAN VIEW INVERT ELEVATIONS I. THIS PLAN/S FOR THE DESIGN AND CONSTRUCTION OF THE SEWAGE DISPOSAL FACIL I T Y ONL Y. SCALE - / = 20 < _ - 7'"� INV. AT BUILDING _�L�Q_ �F��N Of Ma,r,, 2. ALL CONSTRUCTION METHODS AND MATERIALS SHALL CONFORM TO �� _ IN AT SEPTIC TANK(IN) _ _ �� , O MASS. D.E.O.E. TITLE 5 AND THEt / ;Y� .�_ BOARD OF /�L3 �� "/NV. AT SEPTIC TANK(OUT) _ _�o"S� ( w ,,;,� <; =� '� HEALTH REGULATIONS. ,I �A- YN r !v r : ?9�.� ^ t . 3, rI� StPT/C r`,�T EM ��SIGN SHOWN / u E ?ECT TO R'' yR,„� f, �w�►sory T_ I \I °1 H N APFRovAt A5P-Z) (ipt.)// C:0A?PAT'fik4lLiT Y O F -50 `lS IN AT DIST BOX ON) 71IET�R 4iNED $Y' 7,,YZ B4fiR,D . Nr'T! F- ;�� 8c7/1RTJ .,:)F HF-AAI N '>/'_/NV. ArD/sr. BOX(avrJ _ �,�,6_r_ ` 4 � ssyi�f�rti/ "7'G 0009S f'f'ti_R, 7-0 �0IV57RUGTlON . � �'� � f,�,&, AT LEACHING FACILITY: 4R97BOSTO - 5. w tiCr r� WAr4-,R t.i/V a Gtdo"E6 z�O wArA A./Naa �� »�� tii�•�s Z;"Ac.c Par r%v>> c u,-:e 1z — HALIFA , MASS. N ORCELL, MASS. cr AT BOTTOM OF PI T= 44.30 HALIFAX, MASS. NORWELL, MASS. GG.r+Se^S /y4^Ci P.P�S3uR Ipli►Q, qj � BEDFORD, MASS. LEXINGTON, MASS. L ' T' y� HYANNIS, MASS. MANSFIELD, MASS. Q CRANSTON, R.I. DERRY, N.H. O r �r 'R 7 �kl- • B C l.. i a Gr', ©� (•;t'3/.�?r5•• � 56R��V,t N �'�r�� � "-�7•-TT^,'�• ,. � , �. �•= ss «� l �''� z+r,9r N�rt '�<' ,DESIGN DA TA : DESIGN FLOW mox -19 r oc ar REQUIRED SEPTIC TANK: �•o n �'' F`:_ 'S,_:Fe Ph::IH;.vtL7 .�•14�tX" .•.- `,� � � W.ry �ucarr:Q.v �✓.v,- �' _.._ -v._ .,.__-- ------- ,� - 3 GAL. S' o SEPTIC TANK PROVIDED = �s2� GAL. CAPE COD SURVEY Z 0 7- CONSULTANTS REQUIRED SIZE LEACHING FACILITY- ROAD CONS S k -'� C �� _----= - _ --------- 76 ENTERPRISE �' -- -- — - - HYAI�tNIS, MASS. 02601 .. . ys: .. -- - -- - ---- ----- (617) 775 -715 5 , -.�. •----_-_. -_ .... ....-., ._-- ------- -- ------ - -- - ----- 775 -7815 - • , � �• t. �:.TE�1°5 ^rwas ..n,I �aaR i £'� T� / w . .•,, =�..� _...�.. - �' - _-- - _.- --- BOSTON SURVEY CONSULTANTS INC. Via` JI3FJ%� DIVISION OF " . _. .. -- • ,� ., _._.. �„r,N.r:r.r.,• ��.d�._ <.• ..,.. _' � ' .. r•G ,.,,P'�j- "--' -•—� ... ._ .. _.__. .-..._ .' rJ' DIV �A.:.�I'z.�T•iT" Pa:<i�c �;a.:.[::., .}•h„ a,e�v.a.Tt)w.E .: ., a� -., - _ � r,�, I *••�` _ - ��/Y;: - - w•d�- SIZE OF LEACHING FACIL I T Y PRO VIDED: ENGINEERING • SURVEYING • PLANNING �i•'T t .:..qNG om - ;; TYPE OF SYSTEM .� I�.:r ,t /� 's T�v TITLE: CL'L, - �E-;N i%, :`i�= ,nr�3:.rf' Q U f' ,. __• 1 ... _.- - _ •..,. _ _ -`.' '-- �� `` f,�, ' . ' ...... ...L --- ---- l�Q��_��2�2�f�'_Ls2 CZ•r'-'� --��� - ~�----• SEWAGE DISPOSAL SYSTEM DESIGN --- K"• ---�.._ ...` ,�, , .• �• ... ram...--.�" .. -vA L � T L OCUS PLAN%�/f1�. r •��-RI 0�•7 •/��G } ,.•� /Ir L ! yf.i� f.rr•. . �c. �` ' �--� � S`or�oar.t .i `-,gam •._ FOR: E � f '� �' SCALES AS SHOWN Y� METERS jr ire FEET 0 /o ZO 4o 05 DATE: /4PITIL 12') 19RZI COMP./DESIGN: CHECK: JP. P. Tr., / .. ,w, ----- �DNF: DA TUM• DRAWN: f=RC IV T 3c. / 5/oE i<J ' B rr7 ctSe'1 = ��7 E/_, yy.�.i N,G:✓o, FIELD: n'lG.c.�? r 'S, v e, --- r�`:� ": FILE NO: � 10Zr1V,D ,o/Tc.w 14,V.D S rATLF c zFwre,/F oc DWG. NO: &33 JOB NO: 5 77417,6` ve r Sc r /,v SHEET: I OF: I