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0183 ZENO CROCKER ROAD - Health (2)
n d CXDC -r Ropirp ur0rzr M-e SMEAD No.2-153LY UPC 12934 amead.com • Made In USA �cvc� 3 S � 1�- SUSTAINABLE FORESTRY INITIATIVE Cxrtlfied fiber limmino wuur.ufipreyammp f: e FEs.�:.� ......... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH 0(4j.. `- ....-..... .1..` ........................... Allp ira#ion far Digpuiia1 Work,i Tomitrurtion thrutit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: •----�'-�-.� ':-�.a................. i... . .F.?..... _... � Location-Address -or Lot No. 5...... -•--•-•-------- •... �Z'1�--_._1. 1 �-.... ................................... Owner--� 9ddsess 'Installer Address Type of Building ✓�, Size Lot............................Sq. feet �-, Dwelling—No. of Bedrooms_______________J..._..____..__________.__.._Expansion Attic ( ) Garbage Grinder ( ) a`4 Other—T e of Buildiii yp g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) � Other fi3 wes .------••---•----•-------------•----•-----------•-----.--•------•----------•••-•-•------ ...................... , W Design Flow---_..........`J____..........f...........gallons per person per day. Total daily flow............. _---- __-! ..............gallons. WSeptic Tank—Liquid capacitv_10�%G_gallons Length AYTV.•-. Width................ Diameter__________._____ Depth................ Disposal Trench—No________ ____________ Width.................... Total Length..... ___._________ Total leaching area.................... ft. Seepage Pit No._______-I:---_-.f D - Depth below inlet..... Total leaching area_Z4�2..__sq. ft. Z Other Distribution box (�') Dosing tank ( ) a Percolation Test Results Performed byw-T& L _._ _ � ��_�_ � ............ Date....I Test Pit No. 1._ ___minutes per inch Depth of Test Pit....t�.......... Depth to ground water_____ �..... (� Test Pit No. 2..._............minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 x Description of Soil----••-------- - �-- ) 1 _ r p -s�. L._ --- ---- 1✓-----_ ............... �._ U ---------------------- =------------------ •----------------------------- •------------------ .... --------------- ----------------------------- W U Nature of Repairs or Alterations—Answer when applicable................................................................................................ -------•----------•------------------------••------------------------•------••-----------------------------------------...---•.....--- J Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLL 5 of the State Sanitary Code—The unders- ned further agrees not to place the system in operation until a Certificate of Compliance has beeAse tth bo d o alth. -- d -------•........................ Application Ap roved By........ ... .._ ''=/`....:...' ��_ • .......... --------•••••-•-•- Date Application is , prov or the following reasons:.................................................. ................................ ' Yr _ _._..._-•----------............................................................................................. -----•------•-••---------------------- ��— ¢ Date Permit No.......... = ' .�. .y-------------- Issued_..............` �.. ................ D e• LOCATION SEWAGE PERMIT NO. V I L L AGE +� } C it\ntC'y I ALL, I N S T A LLER'S NAME & ADDRESS K_oo �3P-1 z � rA S U I L D E R OR OWNER 4 Souow-S ©DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 2-4- 'Nz LF„ ... Fin$............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................OF... ..✓.. _ .Y..-........................................ Appliratiou for Diipu.ial Workg Tomitrnrtinn rumit ` Application is hereby made for a Permit to Construct '�/) or Repair { ) an Individual Sewage Disposal System at: - _............................................. i .---^-y--�--------------------•-• •-- ••-.......- • Y r Location s .............I C� G) '[ t ! L a- t` N t-i or tI"i, ............................................................ Owner Address W Installer Address Type of Building 3 Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Other �xtnres ....----•----•---•-•-••-•---•----•--•--•-•-••-••----...-••••-----•-••-••--••-----•---.. ................. . W Design Flow...............................��_��..??_:_____._gallons per person per day. Total daily flow........_.__.___-_-_•-____--•-----_.•_-____-gallons. WSeptic Tank—Liquid capacityY�Uv_.gallons Length R..... Width................ Diameter....._..._____.. Depth................ x Disposal Trench—.To: :................... Widt�?__.__j-_-------_-__• Total Length-----_.___._.i..... Total leaching area... .............sq. ft. 3 Seepage Pit No______ --------Z. Diameter------12------__ Depth below inlet_......_._. Total leaching area_.A '_...sq. ft. Z Other Distribution,box K Dosing tank ( ) /` W Percolation Test Resu o Performed b}�_________________________...�..........._..._.......__....__.._____. 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........................ O / ............. _ _ L)0 Description of Soil --•------- `� -- _... Gl' r�tU i .! ------------•--••- - - . - - ----------------------------•----- .... ....... . x 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 TT T, p 5 of the State Sanitary Code— The under igned further agrees not to place the system in ,7 operation until a Certificate of Compliance has been ies y t e b L rrd ealth. Signed........ -- •----- ---- - ..................................... ✓---...... . J L Applicatio pproved •.............................f- gJ'�,_: i g . 31 Date APPIi ,• isappr v d for the.following'reasons-----------------------------------------•_..---------------------------- ................. -•-••-------- Date Permit No....� .:�. _----------•--_-- Issued........................ ............................... Date THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTK.-_..- A %Tprrtifiratr of Toutpliatme T IS9 IS TP ERTIFY,, 4hat the Individual Sewage Disposal System constructed L ,,,)...or`Rep-fired ( ') by � f` _ < %z" ---------------- _ . .._ '•s P.......... , . tEom- .......... at.. ram -r ------ Kzz=---•! a ,..... ------------- has been install d in accordance with the provisions of TITS j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated_------------------------------------.......... THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CON TRUE® AS A GUARANTEE THAT THE SYSTEM WILCFUNCTION SATISFACTORY. �Q' S DATE... --- ...... ........ ...----••-•-••----••-•--...... Inspector............ - THE COMMONWEALTH OF MASSACHUSETTS BOAR10) OF HEALTH ®F � ......5... .. =Y ............. FEE .7' .�.-�,•��^ r•:'`�' L f' .................... ., ,� ,s ;r.�•• No..�'.--'---`-. � .. >_......... Bbipvssalvryq,YTono#rnr$ion (amit Permission is hereby granted............... to Con r �o Repair (. ) an Individual Sewrage Disp �Ystem , at N .•....... r ..... Street as shown on the application for isposal Works Construction Permit L �� v . ' --- Dated........-/-1 --�-- Board of Health DATE.............................................................................. FORM 1255- HOBBS & WARREN, INC., PUBLISHERS .r f� n SITE PLAN sHEEr I OF 2 SCALE:. / . Zo' oo' y o x S 4I><2 t o o Un.1., O C'IZ I✓GA--,-( Gc 0 Sid(�'f I G TA,►.S I(-0 (oDO GrD•l�, l..SAL I-1 I�l r 0 �z � ►•� . 2 7' 0 G�oX rj P20 P,.�i 'u,V- OWL, 0 • ,e I ! I ►-°T ' q ��T `7 j i 5vu.2 I on�ao' I . r OF Mq� WaLuAlw WARWICK H �n No. 19771 /STER��Q1" t U, S� _ FOR- REGISTERED LAND SURVEYOR ZONE- '�� ��J-�Ef��✓ I t_l.A�; r M PLAN REF. DATE `I r q 7 i BENCHMARK DATUM 1�1 LL17 SUQV r--`r WM. M. WARW/CK.a ASSOC., INC. DOMESTIC WATER SOURCE BOX 801 - NORTH FA L MOUTH FLOOD ZONE. N o r-I - I�t �.�zA{x.p �G�� MASS. 02556 - (6/7) 563-2638 N �«. LEACHING BASIN SECTION NOT TO SCALE -o7 Z 24C.I.MH COVER EARTH F/L L BRICK AND MORTAR COURSES AS REO'0• TO BRING GRADE COVER TO INLET B FLOW LINE p'_ "TO "WASHED PEA STONE FREE Of IRONS, P/PE FINS AND DUST IN PLACE T; . . . OPENING W/r// 4%8" ' L Y4" TO l%2"WASHED CRUSHED SrONf FREE OF OUTER DIAMETER IRONS, FINES AND DUST IN PLACE AND I•Y4" INSIDE • .:. DIAMETER :: . , �.•' ; I. CONCRETE TO BE 4000 PSI 28 DAYS .2. REINFORCED WITH 6"x6" NO. 6 GA. W.W.M. 3. 2�AND 4' SECTIONS ARE AVAILABLE FOR GREATER DEPTH REQUIREMENTS 40" I—�� -6 0" , I �l�—I 4. NUMBER OF PITS REQUIRED yN� MIN' i 12 NOTE: EXCAVATE TO ELEVATION .�pR EFFECTIVE DIAMETER (Nor ro EXCEEo S 'TIMES EFFECTIVE DEPTH). LOWER AS REQUIRED TO REMOVE ALL WATER TABLE LOAM AND CLAY BENEATH PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN TYPICAL PROFILE GRAVEL TO DESIGNED GRADE. /8"STD. Lr. WGr. C.I.MH COVER 2..0 4"C./.PIPE 4"8/r.FIBER PIPE FLOW LINE TIGNr JOINT T OUTLET LEVEL OWEL L/NG TO FIRST dolt#r - D0 ,v i 14 O O 1 1 0' of of C.I. TEE 'h� p ` 1 1 0 I 0 1 1 �1100 00 1 1 1 �TO, PRECAST CONC. Gr ,� D/ST. BOX TO BE QV :1 It 0o 00 1 1 1 1 �QGAL.SEPTIC TANK. INS AL1 L ED ON LEVEL, 1 I 0 O 00 0 1 " STABLE BASE 1 11100 O 0 1,1 I i \SEP lC rk" To BE 1 1 9 0 O o 1 11 INSr L D 0 LEVEL, it 10010 E 1 STABLE BASE. i 11600 0 0 1 1 1 1 111100 001111 LEACH/NG BASIN , BASE TO BE L EVEL ; ; 8 0 O 0 SOIL AND PERC. DATA PERC. RATE MIN. /IN. TEST PIT NO. TEST PIT NO. 2 . 0 0 TEST BY - el 1z"J L-rG 41 ►-P i Tkp ff_/yvr�5 9 WITNESSED. BY: K i=ffv D GI.I✓AN 1�/4Ia>t�J� 'TEST PIT GR. EL. DATE: l0. 2 Is' i�l 0 41zN D. 1tiJ A.T�c� �j°�,o. .• DESIGN DATA GENERAL NOTES BEDROOMS NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. DISPOSAL SEPTIC TANK, DIST. BOX AN LEACHING BASINS TO BE STANDARD 1 EST. TOTAL-DAILY EFFL- aGPD. PRECAST. REINFORCED CONCRETE UNITS. SEPTIC .TANK 1 moo GAL, ALL .SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE SIDEWALL AREAL2,GAL./SQ.FT. TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE, MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF BOTTOM AREA GAL./SO,FT, SANITARY. SEWAGE EFFECTIVE ON JULY 11 1977. LEACHING REQUIRED z..`�e.SQ.FT.. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD ACTUAL LEACHING AREA OF HEALTH. z� SQ;FT. '' :r,.AT -COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE BOARD OF HEALTH SHALL BEN NO TIFIED FIED FOR INSPECTION. PITCH ALL SEWER LINES 1/41 / FT. UNLESS INDICATED OTHERWISE. Sti OF SE WA DISPOSAL M SYSTE Iw MORAY �F f23417¢Q, .� LGPpG L"�ey �yy� �UUAL i� SCALE AS INDICATED DATE WM, M. WARWICK 8 ASSOC., INC, . BOX 801 - NORTH M4 MOUTM ` OZO56 (¢lT� 56,E-2639 PROFESSIONAL ENGINEER MASS