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Home My WebLink About0049 GOFF TERRACE - Health (2) C,6,-w 1-7 THE COMMONVVEALTH OF MASSACHUSETTS BOA -OF HEALT II ... -:..........OF.....L.....: l. f�....:�..k._ !/.. ----- ApplirFa#ion for Diipniial Works Tnnitrnrthin Prrmit Application is hereby made for a Permit to Construct ( %) or Repair ( ) an Individual Sewage Disposal System,a A .------------_tk...CIF...-- r� lam_...... .. ............. Locatio - ddress or It No. ..�_1l. ... !/.....VC-1...-------•---•--•------- ----•- d:l:f ��(�crfw- Owne� Address Installer " Address Q Type of Building Size Lot... t _��_ -------Sq. feet U Dwelling—No. of Bedrooms..................... ._._....___..__Expansion Attic ( ) Garbage Grinder 0j10 Other—T e of Building No. of persons____________________________ Showers — Cafeteria Otherfixtures ...................................................... W Design Flow........./... ..........................gallons per person per day. Total daily flow........._.__!_.Q...................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----------- --- iameter---__-__. _.� _.__ �,a__. Depth below inlet____________________ Total leaching area.r.A.(Q_�...sq. ft. Z Other Distribution box ( Dosing tank ( / `" :__ Date__ 9.1 Percolation Test Results Pe byU.ih�.A__►_ I_ ...1.__ /!rl�_ � _ __ ��_� �_ ___ ___._ _.. :___ Test Pit No. mmutes per inch Depth of Test P'It... `f� De to round water____N...� l P P P .____.. g (s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ �+ ----------------------------------- •Ze .1I n.... i- Description of Soil..... _4? _ _I_Ll - �' �i .�C�_ ,�• ----------------------------------------------•------------- U •------------------------ ............. ---•--C--.'-"�'" = ' f0 --® �...........--..........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 iITL; y g g p y 5 of the State Sanitary Code— The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has been issued by the board of health. Sig ----- • ------------------•--__.--_____-___................................. --------- ................ Date Application Approved By....: __yr y_ Date Application Disapproved for the following reasons:----------•---••--•---•----•------------------------•-------.................................................... -----------------------------•----•-•----- ---•--------•---••---•----•------....._......--------------••-••---•--•---•-------•-..........-------------- ........................................... Date Permit No. Issued_../ ..'. '`. /... Date' .................... THE COMMONWEALTH OF MASSACHUSETTS BOARD-OF HE � H � --------------OF.... ..:.... " 4P....1.1-4. ............................ App iration for Biipoaal Workii Cfoni#rurtion Vautit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Systeuq a .6 ... ........................ Location TjAddress or Lot No. Owner.. ,...�. A ress ,.a Installer Address dType of Building ;" Size Lot_'__S.j1. ........ feet Dwelling=No. of Bedrooms............................................_ Expansion Attic ( ) Garbage Grinder ( ) ,Other—T e of Buildin .............. No. of ersons---.•-_.._._________.___-___ Showers — Cafeteria f4 YP g P ( ) ( ) 04 Other fixtures ..................:............ .. W Design Flow......../J.. ...........................gallons per person per day. Total daily flow.......... _1._:,--...................gallons. WSeptic Tank—Liquid ca.pacitylM.W.gallons Length.......:........ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width..................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No---------------_---- Dia m eter.,,......___........ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution,box ( } Dosi g tank ( ) Percolation Test'Res lts Pea�formed by __l___ 11f. .. .............. ............... Date.__, _� . ._.7... ... aTest Pit No. 1 C'FS............minutes per inch Depth of Test Pit___________.......-_-Depth to ground water--___---_-___-_.__--.--- li, Test Pit No. 2................minutes per inch Depth of Test Pit.................... bepth to ground water........................ Description of Soil ��d7> iii4 .. ,1 C o I.F R VNature 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 TIT12 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. Sied_: ............................• •----•---------------------------•- ................................ Date Application Approved By , ':........... ,/ !` r D`�1---------- Application Disapproved for the following reasons: ----- -------------`=--------------------------------- ........................................ ............................................................•....._...................--....:._i_.........__..............._ "----...._.............-........__.__.............................................. Date PermitNo......................................................... Issued.............................-........................... Date THE COMMONWEALTH OF MASSACHU,SETTS' BOARD O', HEALTH ............OF...f7.�..7.A�.:.F) ..t. ...... :............. Tatifirtt#r of Tontnlianrr tY THIS IS TQ,CERTIFY That„be Individual Sewage Disposal System constructed ( ) or Repaired ,�..�. ��.- .. W. ( ) by-•--... .#.......:�la?.k...�L�C-�,? k...�------- -------- --•--•-----------------••--•---------•----------........--•--•-----•----------•-. rC-L4 A f Installer e ` at---- ° � '��--------... a'C� l ..............................4 -------- (--• t1_1._- L(. ............................................. has been installed in accordance with the provisions of ` of The State Sanitary�ode,�as described in the application for Disposal Works Construction Permit 1 o:___ ..___V/__�"�._.__..__.. da.ted__ 10_.-tX.t.7._ _ T - - - - THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. 17 `7 Inspector........ — .....DATE--•------------- - THE COMMONWEALTH OF MASSACHUSETTS BOA OF HEAL.IH �'� ............OF.... ... ..� .. :: 5 :....:.................. N r/' .. FEE.3V............. Disposal Vork.5 To ng ti tUan. amit Permission is hereby granted.. ±�f O. LJ.f ....................................................... to Construct ) or Repair ( ) n I ]jvldual Sewage Disposal s �r tem V at No..: u �i.- r j. './1. = .......... .�•. r" . - - 3 Street as shown on the application for Disposal Works Construction Per o....... _ 4. Hetalthq ed._tU %T''_7f........... •----•--.-------•-_--•--_ o DATE................................................................................ 7 FORM 1255 HOBBS & WARREN. INC., PUBLISHERS `�� y • -+.:,��r �: LOCATION SEVA E PERMIT NO. C-119.—.. VILLAGE 0 eel INSTALLER'S ,NAME i ADDRESS vT11h U�- dam; ,LO--r✓ 8UILDDEIII OR OWNER es - DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED K w`V i V ! C` cy'1 p jS ¢S7 62-,4B. 774 P/r o�C LoT 't6 0 �st,3r,.�G 0 s FovwD/YT►a+� Z07- JreI� I 431 1 �lkti E'L./r�YA'T/O AJ S (3�9aE'D GN AS S(/H�D A4jUI'� CERTIFIED PLOT PLAN LOCATION .✓iCL. . . ;1;ti n• SCALE . 30'. . . DATE scar 7-7 i979 7N �o y.r PLAN REFEREAICE a� C T l .9s -T/o nJ 2 L�.�18��T iy iLG S . I CERTIFY THAT THE !ST/NG /Dr�.wb4�7o.v SHOWN ON THIS PLAN IS LOCATED ON THE GROUND C>o GJ� 7 c ,eiq e�- AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF . . . . . . . . WHEN CONSTRUCTED. / 7�pieN7V/-/ 410/V6- DATE PETITIONER: I-AIA A115 / "4 5,5 . �(r, 74� REGISTERED LAND SUR OR N59345 e- s/�-�r� � c� z sic•rs L. 4�/. TOP OF FOUNDATION CONCRETE COVER CONCRETE COVERS a 4' CAST IRON 12"MpX. 12"MAX. PIPE (OR ' 4"ORANGEBURG(OR EQUIV.) EQUIV.)— MIN. PIPE- MIN. � PITCH 1/4-PER. LEACH ° PITCH I/4"PER.FT PIT e PRECAST N VERT . Q LEACH I N G ` ° EL. •.2�?... INVERT INVERT o . e•; PIT OR e SEPTIC TANK 4SZZ DIST. 4�7z, , w EQUIV. INVERT EL....-. . . . . BOX EL...... >= 0: .�• o; EL.4S39.. /000 GAL. INVERT INVERT ;' ww p 3/4"TOIVZ � EL.YY.YY•r�f •¢3 WASHED S I w TONE I'sI �— • . ., �' /d� DIA.---+-� NONE PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE SOIL LOG WITNESSED BY : DATE?� . 7/ i979 TIME.9. .j�!4!7 �' �' ��. . . . BOARD OF HEALTH TEST HOLE I TEST HOLE 2 7I10r1L�5 • ! Z1.�! P - , E N G I N E E R ELEV. .¢7. . . . . . ELEV. .. .. . . . . . . / WeoDCo,to•� .�. . DESIGN DATA `'• SLP_So,L NUMBER OF BEDROOMS .3 30" TOTAL ESTIMATED FLOW . .3.3a. . . . GALLONS/DAY BOTTOM LEACHING AREA SO.FT. /PIT N�7�iury SIDE LEACHING AREA . .i88:S SQ.FT./ PIT GARBAGE DISPOSAL /VUNE •(50% AREA INCREASE) TOTAL LEACHING AREA SQ.FT a PERCOLATION RATES. !Q'!a. T!✓.v. MIN/INCH !yO. LEACHING AREA PER PERCOLATION RATE S .Q.. SQ.FT. .WATER ENCOUNTERED W�ThI,71n/p. • NUMBER OF LEACHING PITS / . .PiT APPROVED . . . . BOARD OF HEALTHZT of- !�E O�/•At.4. S/DES. ? /Sf rpvsl~ a/-- Z-/DA/.C-, P4-X AT. DATE . . . . . ;rkbMAS E:KELt EY Co.• . . . . . . . . AGENT OR INSPECTOR ENGINEERS—SURVEYORS 346 LONG POND DR IV SAUTH yARMOUTH,NUS06 / OF QZO64 M� 7—t�� s! `tN OF NASA 2 THO n+ EDWA`• f EY n No.24260 O v� 2 1 J�O .e9�F�, P4; I.V& z��cT�4�yo� C' O��'r+�10 At- PETITIONER /Yf��$ � 4� � S�fiv