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HomeMy WebLinkAbout0192 ZENO CROCKER ROAD - Health (2) .11 2 Zeno Crocker Road 170-126 t en tervi l l e,=, No. 42101/3 ORA Paacokolv@SKO 10% (D o © © o i No...... C�...._.,tom.. �i Fimic r THE COMMONWEALTH OF MASSACHUSETTS G BOARD OF HEALTH AppitrFata�an for Uaipnsal Works Tonotratrtion Prrutit Application is hereby made for a Permit to Construct (el-or Repair ( ) an Individual Sewage Disposal System at: _ ................................ Location:Addre� 7 or �,ot No. • L/9 L- r3 rA -oR u ,. ._....1. .►.`� '-r �. ._: :. _ i hY. .. .... . •_S.j. ..................... Owner Addre a ---------., �G ,� ... rlr`' l ��,Tl----------- ----- 1.� .........._ :5....... nstaller Address Type of Building Size Lot_ .�F_VeO_......Sq. feet Dwelling—No. of Bedrooms................................._..........Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons_._._._..____________________ Showers — Cafeteria a' Other Lytures _________________________________ Design Flow___________ __ _.gallons per person per day. Total daily flow......... ____.___._________ lons. W g ------------------------- g P P P Y• Yam''--- � WSeptic Tank—Liquid capacityk-ev gallons Length---�,tVj?. Width................ Diameter................ Depth................ x Disposal Trench—N _____________________ Width--­--------------- Total Length.................... Total leaching area......... .........sq. ft. Seepage Pit No--------- Diameter._.__.f'1/____ Depth below inlet__43.'�_.___. Total leaching area_ A ___sq. ft. Z Other Distribution box Dosing tank ( ) I _ Percolation Test Results Performed _________________ Date...... 0r . ,aa Test Pit No. L__ji�__minutes per inch Depth of Test Pit-----A°�_.____ Depth to ground water....... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •-•-------•-••------••---------•--•-•••.........................••-•••-._..._..c......... ----- Description of Soil - '`-y- -•-------•------------- � � - o� C� ------------------------------------- ------------------------------------------------------------•----------------------------- ----------------------------------------------------------•--._....__. ; U Nature of Repairs or Alterations—Answer when applicable............................................................................................... -------------------------------------------•----------•----•-------- ----------------------------------------------------------------------------------------------•-------------------.............._. Agreement: The undersigned agrees to install the aforedescribed Individ 1 Sewage Disposal System in accordance with the provisions of iITl1 5 of the State Sanitary Co e— The un si ned further agrees not to 41acethe ste in operation until a Certificate of Compliance has bee • s by o f health. Sined •• --• ••• -•• - -- •--- ----•- ,� a Application Approved BY -••--••• �_� D e Application Disapproved for th f 11owing reasons--------------------------------=•-•-•-.---------_..-----------------------------------------•-•-•--------••••••- ........• a i � -• Date rmit No.....T... . .Z ............... Issued-------- _�_1.. . Date No.----.:. FEz............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................................._....OF...... Nopfiration for Uhipasal Worka Tomitrurtion rnmit Application is hereby made for a Permit to Construct (�or Repair an Individual Sewage Disposal System at: ................................ Location-Address or T�of .........................ed, No. M.XS.3..:..................... Owner Addre -------------7--­---------------------- ....... ... .. .1;-_A 4-414. .... ........... ...... ... .. ........................... Installer Address Type of Building Size ......Sq. feet U .31 Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder '_l P4 Other—Type of Building --------................... No. of persons............................ Showers Cafeteria P4 Other I ! fi ures ......................................................................................................................... Design Flow___________; ___________________________gallons I per person per day. Total daily flow.......... .________.____.___gallons. 1:4 Septic Tank—Liquid capacity-VOW-gallons Length--- Width________________ Diameter-_-__-__________ Depth______._____._.. Disposal Trench—N Width.................... Total Length________.._.___._.__ Total leaching area sq. f t. Seepage Pit 'No.......... -------J.'L ..... Depth below inlet___tij3......... Total leaching area_..........`�)...sq. f t. Z Other Distribution box Dosing tank Percolation Test Results Performed .................-'Date...... Test Pit No. ---minutesperinch Depth of Test Pit______a—------ Depth to ground water_--___:---______._.... ;Xf Test Pit No. 2................minutes per inch Depth of Test Pit__.______._.________ Depth to ground water...___...-______._.__._. ------------------------------------ ..........................................t..........r.................................................................. 0 Description of Soil..........4::�,-_Z•..... 4�-,C.;A - , -e. ......... .......... ....... ....................... ................................................... U ........................................... --- ...... !�. ........................................................................................................................................................................................................ U Nature of Repairs or Alterations—Answer when applicable---------------------------__................................................................ ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individ�l Sewage Disposal System in accordance with the provisions of TI T U 5 of the State Sanitary Code— The un si ned further agrees not to place the.,4stem in operation until a Certificate of Compliance has bee sV b o f health. (-7 Signed...... ..... ...................................... ...... ...................... 4 1 , [a Application Approved By.......... ----------------------------------------------­­-------------*---- ------- _e Application Disapproved for th 11owing reasons:................................................................................................................ In 'V" The n u t S, 0� h ,&of"heal.th_ . .... ........ ....... ................. Date --------------------------------------------------------------------------------------------I...... --------------------------------------------------------------- ------------ 041lermit No.---T... ------5- 4.70---------------- Issued_ ------------- Date THE COMMONWEALTH OF MASSACHUSETTS 'BOAR;DY'9F .HEALTH .................................................................................. F .. ............. (9rdifirake of Tautpliatta THIS IS TO D*sr) sa constructed L4__O�r �ERTIFY That the Individual,.Se�wy,�ge., is ol System Repaired b . ......... ....... /-------------------------------------------------------------------------------------- I &1ler at........ ....... ..........�?_ ......................................................................... has been installed in accordance with the provisions of TITLu 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No_________________________________________ dated_._......_._._...___.__..._......_.__._._____._. 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 F HEALTH ..........................................OF........./ 0/.1111�1....................................... No......................... FEE.... .1.40.......... p A Permission is ��eby granted------ ...... % ................................... to Constr ct or R ` (, -) Re an Individual S�n Disposal System at No... ...... Street as shown on the application for Disposal Works Construction Permit No_____________________ Dated___________-.__.__.__:__..___._.__._._.... ................................................................. ....................................... Board of Health DATE._-____-... ................................... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS 1-7D 4100, OCttATION SEWAGE PERMIT NO. VILLAGE I N S T A LLER'S NAME 4 ADDRESS I� I� S U I L D E R OR OWNER L S©a �s DATE PERMIT ISSUED D A T E COMPLIANCE ISSUED Z � y � `�, ,�: ry .. ,, o , o r�� r S/TE PL A N SHEET / OF 2 SCALE: / . zo I vo. o 0 (vow G,�.L . �•�:.�.�� �i-j' RAJ T�-� 3 ' h'i"oN A►f-dvO P 0 _ v 1 hT, vJ v1G 4�X � Ivvj ��Q ! Y I 0 i _ .. l000 G•,b.L I N O � PTiG TtI �,JK -O 0 0 I O P 0 FL.�L,�j1.5 i N Ai 0 tLtc I + 3 1 � I�� vv� ►;zS I I z27 j iV Iv0,0o' tN OF Mq�, VMWLUAM M. WARWICK NO. 19771 �FCISTER���� lAMO S 'I ,Qllw • �(�(� FOR L.. F�.lr'a�!•.•.....f..y J L L..t:��t./ � RE61STERED LAND SURVEYOR ZONE S G t~� -1" F P` t L L-V M � PLAN REF. DATE BENCH MARK DATUM 'f' ( �(� WM. M. WARWICK 8 ASSOC., INC. �1 ��- R �•� ��• DOMESTIC WATER SOURCE-s' \4-) 8OX 80/ NORTH FA L MOUTH FLODD ZONE. MASS. 02556 - (6/7) 563 -2638 � r LEACHING BASIN SECTION NOT TO SCALE spec z o7Z Z 24"C.I.NH COVER EARTH FILL BRICK AND MORTAR COURSES AS RE0'0• TO BRING COVER TO GRADE �B FLOW LINE _ l INLET / _. i 2` 1g"TO/" WASHED PEA STONE FREE OF IRONS, PIPE FINS AND DUST /N PLACE OPENING WITH 4%B" /4 TO //2 WASHED CRUSHED STONE FREE OF OUTER DIAMETER IRONS, FINES AND DUST /N PLACE AND /3/4„INS/DE D/AMETER ' • I. CONCRETE TO BE 4000 PSI 28 DAYS Lrea a,�,h p, 1• 2. REINFORCED WITH 6%6° NO. 6 GA. W.W.M. 3. 2'AND 4' SECTIONS ARE AVAILABLE FOR I " GREATER DEPTH REQUIREMENTS 4p., --I60" �I --, 4. NUMBER OF PITS REQUIRED MIN. I 1Z NOTE: EXCAVATE TO ELEVATION-,-37. 5 OR EFFECTIVE DIAMETER (NOT TO EXCEED 3 TIMES EFFECTIVE DEPTH) LOWER AS REQUIRED TO REMOVE ALL - - - WArER TABLE - LOAM AND CLAY BENEATH PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN TYP/CAL PROF/LE GRAVEL TO DESIGNED GRADE. IB"STD. LT. WGT. C.I.MH COVER V.: 4"C./.PIPE BIT FIBER FIBER PIPE TIGHT JOINT OUTLET LEVEL DWELLING FLOW L/NE TO FIRST JOINT -- - , t - /0"1 �4. oo I10�00 11 _4`• I. 4f,0 y g 1 1 0 0 0 1 1 c C.I. TEE � It000�00 11 II q3 4g•°u .'STD. PRECAST CONC. g5•�ti �D/ST. BOX TO BE rslfj (0 ' 11400 O 0 I I 1 i Iv40GAL,SEPTIC TANK. INSTALLED ON LEVEL, `- 11 1 1 00 0 0 0 1 1 1 STABLE BASE 1 1 1 000 00 03 1 1 \SEPTIC TANK TO BE 1 1 1 000 0 0 1 1 1 , INSTALLED ON LEVEL 1 11 100 10 0 1 1 ' ' STABLE BASE. 1 1 1 0 0 0 0 0 11100 001111 LEACHING BASIN : i I t Q 0 O O D I „ BASE TO BE LEVEL i 1 1 0 0 0 1 SOIL AND PERC. DATA 41 5 PERC. RATE ` E- MIN. /IN. 0„ TEST PIT N0. P3&-.q5 O TEST PIT NO. 2 i-/SJ roy01 L. TEST BY WITNESSED. BY: TLo1J0ati1 MAD. TEST PIT GR. EL. DATE: Io_ z-- o„ IZ, �L DESIGN DATA GENERAL NOTES BEDROOMS _ _NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. DISPOSAL No SEPTIC TANK, DIST. BOX AN LEACHING BASINS TO BE STANDARD EST. TOTAL DAILY EFFL: 3` GPD• PRECAST REINFORCED CONCRETE UNITS. SEPTIC TANK 1O°O GAL. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE, SIDEWALL AREA?GAL./SQ.FT. MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF BOTTOM AREA LO GAL./SQ.FT. SANITARY SEWAGE EFFECTIVE ON JULY Is 1977. LEACHING REQUIREDZO� SQ.FT.. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD ACTUAL LEACHING AREA OF HEALTH. tiSQ.FT. .AT COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE BOARD OF HEALTH SHALL BE NOTIFIED FOR. INSPECTION. PITCH ALL SEWER LINES 1/4" / FT. UNLESS INDICATED OTHERWISE. SEWAGE DISPOSAL SYSTEM MARTIN :a E. MORAN H L.C2 Q a, ,p rP23417�Q ¢ ? �o� 'als-T t L.L. AA • ��fsc`QliAl ECG Y' 4 SCALE AS INDICATED DATE WM. .M. WARWICK 8 ASSOC., INC. 8OX 801 - NORTH FAL MOUTH ` MASS. 02556 - (6171 5 63 -2638 PROFESSIONAL ENGINEER