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Home My WebLink About0110 GOFF TERRACE - Health (2) _. `.. I i it i �0 — 0 d O Fx$..-3Q ..... THE COMMONWEALTH OF MASSACHUSETTS BOA OF HEALTH ........ ..... ........................ App iration for Mipoiial Work.5 Tomitrurtion ranfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: - ....Q'A de 41./Ph .......................... --------------------------------•--.------------------------.---__•. Location-Addr s or Lot,fo. Owner . Address --•..............•---......._. Installer Address Q Type of Building Size Lot_____ feet V Dwelling—No. of Bedrooms.___..................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of BuildingT),A.%J C Ai._____ No. of persons____________________________ Showers ( ) Cafeteria ( ) a Other fixtures ------------------------------- Q ------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacityJ00Q_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. Other Distribution box ( ) Dosin tank ( ) -�+ fl '-' Percolation Test Results Performed by.. 11a.-1jCQ'l�d_ _1C b l�?7i-•G- -!� Date____ / _! ,.1 Test Pit No. I________________minutes per inch Depth of Test Pit.................... e'pt tb ground water...... ..--------- Test Pit No. 2................minutes per inch,. Depth of Test Pit.................... Depth to ground water........................ .................................--- ....... ._ _...._.._...._.....••••-......•......... ......................................... Descriptio of Soil.(Ufi-4'-1)--••'�_ii �b = ! ! /��rlae4_ 7n- __.._.:----------•------------------------•-•--•------•---••----------------.._.....------------•-------•------••---------------'...------•------------------------•-----•---------------•-....-•-•-••-•- 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 TIT E 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. Sig - •••---•••--••••-•-•----•-•••.....-•-•-•-----•-•-•-------•••-••-•-••••••-•-••-•- ................................ D Application-Approved By--••i �'" �e �� "x'7 L'.IS_ d Date Application Disapproved for the following reasons________________________________________________________________________________________________________________ ...--•••••-•••••••-----••----•-••...••---••-•--••-•---••••---------•--•••-••••••--•-•--••--•-••-••-•---...-----•------•--•••-----••••------••-------•-------••----••=------•----••••-••••---••--•-•--•--- q Date PermitNo......................................................... Issued-----�j F-- 1--r---k........................ Date Fx$.............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH fc - .......oF...- ..... �d.....6 -6C,t`------------------------- Appliratiou for Disposal Works Toustrnriion rnmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal �ystem at: _ :?-v-.#_k.& ......................._.....04.......----- ......................................•... Location•Addci5ss = or Lot No YV U?caner Address W � I Installer Address �n UType of Building t Size Lot..._.._.®...................Sq. feet Dwelling—No. of Bedrooms_.._..................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building 1-!A k4_�A'___.... No. of persons............................ Showers ( ) — Cafeteria ( ) al Other fixtures _________________________________ W Design Flow............................................gallons per person per day. Total daily flow......................._....................gallons. WSeptic Tank—Liquid"capacityhll).,__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 ( ) Dosi tank ( ) ''' Percolation Test Results Performed by. . . �......� ._:.�ftr�?�1'.�.�'�._��_��_�. Date..... !.�'�� a � a� rr • Test Pit No. L______----------mmutes per inch Depth of T st Pit.________..._.._..__ Depth t� ground water______ _.- ,,_...____. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ---------•-•----------- ----- --- - -----••----•--------------------------------------------------------------------------------- O Description of Soil.VAI.1.__..1/u k4.3.______ ___ _____ �.u. _!f_. ---------___ c�` l ---------•----------•---------------------•••-•--••••••-- 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 TIT . . 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. Sign d- ` (� -.. ' r1 Date Application Approved B iv Date Application Disapproved for tke following reasons-----------------------------------------•--------------•--•------------------------------------------------•---- I. ....-•---•-----------•...................•--••-•----•••--••-••..::_...........-•-••-•--••----•----•--......---•---•••••••••---•---•-•------•-----•-•-•-•------•-----••----•---•------------•------------ Date Permit No............................... .. - Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ ..1`.6-eta.�&,j......OF....... . . J�:l..... : �.c................ Cnrr�ifirtt�e oaf f�unt�li�anre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by........ ............-•-----------------------------------------•--->.................................................................................................... at. f= �Y �' - C•_ _/ scalierr� ...............................................S. J -------•-•------------- has been installed in accordance with the provisions of TI ( j cF' QState Sanitary Cie /slaM9AWd.in the application for Disposal Works Construction Permit No..............._------------------------- dated-.-.-__----.-.---_-.-.-.-_-_-_---_----______-- THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONST UED AS GUARANTEE THAT THE SYSTEM WILL FUNCTION SATICZfACTORY. " Ail DATE..................... ....`.. �._.....-----•--.._....-•-----•-------_.. Inspector. •----• ----- ---•• ----- ......................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No......................... FEE........................ Disposal Works TDonstr inn rrmit Permissionis hereby granted...0...-0......0-"_R -••----••-----------.......................................................................... to Construct ( ) or Re air (_man Individual Sewage Disposal S-y°ste>b 1 /f at No....BA---------cry E�-••-...I.. -�'-......- ( {- "!✓ "!--•-=•--•••--• /�'f------ stre t a as shown on the application for Disposal Works Construction Per ....... Board of Health DATE......... ----------------------••---._...-=---------•-•----- FORM 1255 HOBBS & WARREN. INC., PUBLISHERS .SfiC -7- 4¢80 TOP OF FOUNDATION CONCRETE COVER CONCRETE COVERS 0 4"CAST IRON 12��MAX. ° 12"MAX. ' PIPE (OR 4"ORANGEBURG(OR EQUIV.) EQUIV)— MIN. PIPE- MIN. J LEACH ' PITCH 1/4"PER. PITCH 1/4"PER.FT PIT PRECAST o' \—INVERT • LEACHING ` o EL. :BR... INVERT INVERT o . e�; PIT OR EL.•01.40 • . BOX - >_ SEPTIC TANK DIS EQUIV. o INVERT /pop . GAL. INVERT INVERT 0: :;�: 3/4"T0II EL'%r tti o 0 WASHED EL .�4 :,. ° w STONE -_ ' /d DIA.--� A/o�vE PROFI LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE LIMI Y SOIL LOG WITNESSED BY : DATE ��Z;./g7`I. TIME. 9�.jO.'4�1 P �'. �!� BOARD OF HEALTH TEST HOLE 1 TEST. HOLE 2 .7Ab!4i}:* /'E, ENGINEER ELEV. . .4Z-4. . . ELEV. .. .. . . . . . . ` WaoaLepr' / B„ DESIGN DATA 54A6.Soo L NUMBER OF BEDROOMS . . . . `3 3Z TOTAL ESTIMATED FLOW 33d. . . GALLONS/DAY hb-D��7 BOTTOM LEACHING AREA 78.So . SQ.FT. /PIT S.�D SIDE LEACHING AREA . . �88,Sv SQ.FT./ PIT GARBAGE DISPOSAL Nam. .(50% AREA INCREASE) TOTAL LEACHING AREA . .u7, O.a. . SQ.FT s 'D LDS Th�<?+v 7WO PERCOLATION RATE . . . . MIN/INCH LEACHING AREA PER PERCOLATION RATE .5�O. . SQ.FT. ft. .WATER ENCOUNTERED NUMBER OF LEACHING PITS 1 PiT Wif,�I Tt�!v �7- APPROVED . . . . . . . . . . . BOARD OF HEALTH p'c•S7p�E• G,v•,C ,L Si -S, /S,C 7S c�SyaK.0 DATE . . . . . . . THOMAS E.KELLEY CO: /�I v AGENT OR INSPECTOR ENGINEERS—SURVEYORS l•l ' 346 LONG POND DRIVE a SOUTH YARMOUTH,MAW �{OF 02664 �c44 THCAA hill KE �t a J ELLEY H 2 i�? A No.24260 O /lT� !7T?c1 l/ie/VE�. yt , of`Tc_ � AGIST�f PETITIONER ` t;-i �y� Fs NAl 5 u .E. S/O EN - \ ,3 � A , \ N 0 4A, i - LrUry 7-Op oil 'Flu gill ILoT /3 H 189oZ54), F7.- �eo B< Z07-'et,3 .4ssv.�,�v Dfr3v y CERTIFIED PLOT PLAN EDWARD E. KELLEY LOCATION ��ViGG��. .M�4 s S.< .. . . . . FAt1�S. 02637 SCALE . !.��=30'. . . . ®ATE s�`T1T. PLAN REFERENCE .8E7ivG Lv7" ei�3.a A Of ED EARD '� •eo.E�. .IAA/ /z,BAC. IY y / v 231 0,)O I CERTIFY THAT THE Ewa- o �NO s"ice,`y SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF 13AN- - 744?44: . . . . . . . . WHEN CONSTRUCTED. ]%-*-,,Es/7z-)N 7,)R I /C DATE .``�-FT% PETITIONER: }//�;•�/n/i5 REGISTERED LAND SURYEYQ