HomeMy WebLinkAbout0009 JOYCE ANNE ROAD - Health (2) Jo�u, Ann
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No......- �.q------ I F��... �..�..d.......
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
J ............OF..............................I........... ".. ....................
Application -fur Utsv iial Worko Tnnitrnrtion Vrrntit
Application is hereby made for a ermit to Construct ( ; or Repair ( ) an Individual Sewage. Disposal
System at: yz
x
•4 i °T, CCU rt1 . - ..., ..�� - '�.�....................
a ion _.A ress Srtr Lot 1 ��. ..................
-5u r 1 .. .1....... Jug
Ow Address
a •-------.2cf-i- ..........................................T �e-�-.- ----------------
-------------------------------------------
Installer Address
Q Type of Building Size Lot..........:.................Sq. feet
U Dwelling—No. of Bedrooms---------4.............................Expansion Attic ( ) Garbage Grinder (
pa, Other—Type of Building C' P ............. No. of persous---------------------------- Showers (3) — Cafeteria ( )
P4 Other fixtures ......................................................
w Design Flow............................................gallons per person per Ty. Total daily flow......... -----------------------gallons.
WSeptic Tank—Liquid capacity4 gallons Length-___ Width............._. Diameter---------------- Depth-_______---
x Disposal Trench—No--------------------- Width_.._...__..____-_ Total Length------------------ Total leaching area....- ___�__sq. ft.
Seepage Pit No.......�....... Diameter-------j?.t�rDepth below inlet...---FT. Total leachingarea-----b..........sq. ft.
z Other Distribution box 6 ) Dosing tank ( )
Percolation Test Results Performed by-------------------------------------------------------------------------- Date........................................
Test Pit No. 1----------------minutes per inch Depth of "Pest Pit.................... Depth to ground water--_-_-_______-:--___. -.
(Z-4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...........-__-________-
9 -------------------------------------------------------------------------------------------------------------------------------------------------------------
O Description of Soil----------&a_,,pd:ft.......S�p,4.61......y�/t,�9vE ;---------------------------------------------------------------- ------------------------
x .VV ----------------------•---------------------------------------------------------------------
w T� ' % r--T ,
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 Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been ' s ed by the bo r h alth.
Signed--------- ............ tl ----. -9--
----------------------------------------
Application Approved By_-____ �L Ate 7 7
-------------------------------•-------------------------------------------------
Date
Application Disapproved for the following reasons------------------------------------------------------------------------------------------------••---------------
..-••---•-•--••-•-••---•------•-----------••---•---••----•-----•-----•--•--------•-•••-•-------•-------------------------------------------------------------------------------------------------------
Date
Permit No......t—d-l-----=-------------------------------- Issued......... :... 6 . 7 7 .
Date
--
No..-------------
. Fick ......
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.........OF.........................................................................................
Appliration -for 'Uhipwial lVarkii Tonstrurtion Vantit
Appltation is hereby made fora e it to Construct el. or Repair an Individual
Sewage` Disposal
System at:
CgW .....c.r_m
........ "T------------------------------------ ------- ASS.,....... ..........
or Lo lil�o
-5 ZZ,
-----jo
..........
........... .............. t W.................
6Wsikk.r-11.'Vsv Address
..................... ................ ........
Installer Address
Type of Building Size Lot............................Sq. feet
U
Dwelling—No. ----_---_------_----------Expansion Attic Garbage Grinder (
Other—Type of Building .......... No. of persoug--------------------_---- Showers Cafeteria (
0 ly t L_fixtures .....*------------------------------------------------- -------------------------------- ....................
Design Flow.......799W------------ ----- --gallons per person per day. Total daily flow.............40._I'D'-------------------------....._.gallons.-----,
1:4 Septic Tank—Liquid capacity �i _gallons Length________________ Width-------I........ Diameter--..._.._....... Depth----------------
W ' 9 Z5
Disposal"Trench—No. ..._....... Width --- ------ Total Length Total leaching area----- sq. ft.
area.. ----sq. ft.
Pit No leaching ......Seepage --------I ...... Diameter------- ..... Depth below inlet...(;�t........... Total 1)eachii
Z Other,Distribution box Dosing tank
Percolation Test Results Performed -by - -------------- -
Test Pit No. 1................minutes per inch Depth of Test Pit.-.--__-_____-___--- Depth to -round water.......--
(_
Test Pit No. 2................minutes per inch Depth of Test Pit.-_---.---.____-__. Depth to ground water........._.._-._-_..__.
...............•---- --------------------------------------------------------------------------I...............................................................
0 Description of Soil__...__ �Ce_e� 4_$j........... ....... 4
----------------------................................. --------------------------------------
----------------------------------------- ---------- -----------------------------------------
U .................................. - ------I.......... ---------------------------------------------------
7,
rill
------_-_--------------- --------------------m----------------;............... ----------------- ------------------ ---------------------------7-----------------------
"�ions—of Repairs or Alterations— nser- en.,applicable......................................................................................
U Naturer AW"Wh
---------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------
Agreement:
The undersigned the aforedescribed Individual Sewage Disposal System_�grees to instalI. w in accordance with,
the provisions of Article . I of the State Sanitary-4C.ode in in
The undersigned further agrees riot to place the syste
Certifi6ate"".v" 15 the b operation until a o �,Cornpliabtb-Nis been J;�'Q 0
�ed` r
9W,
Signed-_'..'_"i-- - ------------- --------------------------------------------------------
-- ------ -----------
Application Approved By------ ---------------
4- 72
---------------------------------------------------------------------------- ------------ --------- --_-----_---
Date
Application Disapproved for the following reasons:----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------.........
Date
7
Permit No.----'' .................................... Issued.------. .......... ' 7-
,
.................................
Date
fit '
T4E'C' O MMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Af 1
..........................................0 F.... ........... t.... .....-00
......... ...... ................
(Infifiratr of Tuantphatta
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired
b - -------- ................. ....................................................................................................
................ .&t.
�Ier
at.............. ./P...... ------- ............................... ...................... .......................... ... ... ........................................------------------
has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the
application for Disposal Works �T�6bction P -T
�`ty - ---- dated app eriiiii-N, _!r-- ----------- ------ /Y.
THE ISSUANCE OF THIS CERTIRCATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE._.
...... ................................
........................... Inspector4,.................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
................................. ........ .............................
No..:---- ...... FEE........................
P A,
ermission is hereby granted------------- f 41-4-'f-------- 4--------------------------------------------------------------------
to Construct (Y or Repair an Individual Sewage Disposal System
at No.------- A.....44 A
&..............A.............................................
Street 1*'7 7
or"b"sp6sal Works Cc , %1� ,
as shown on,the application fJ, i" instruCrtio&',Pe'r'm'ft,'Vo------- Dated___._ Aj!"� '�"e� ..........
....................................................................................................
Board of Health
DATE--------------------------------------------------------------------------------
�A'FORM 1255 HOE38S & WARREN. INC.. PUBLISH,ER
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�il Sn0 S.�L SyST.,--7A-I ��� RICHARD v r RICHARD
- / 2 50 C,/9/- S F',PT/C Ti9N` JAME! �, 't JAh1E5
- S OUTL ET 1) S T, n0 X v O'HEARPI v O'HEARN ; ti
No.694Pb. 27871�O
IN/TH 1 FT OF STONE G1STriR �i� 4`ICT�,E�
1195 IQp F07U.e1E SA.rtI?iR1P�� \�S etc 9
/N,O/--/?7 ES LOCA OF 1
C�f?T1F/�D 1��07 JaLAV /,A/
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l3.2 aA/:F7:9• L F MASS.
LOT-"YI2-,A:/2t�-
.T CERTIFY THAT THE Kati/✓o/arion/ RICRARD U. O'HEARAI, R.L.S., R. S.
S140WAI ON TI-11S PZAA1 /S LOCATED l9I A fA/N ST. ('RTE. 28).
ON THE GRO UND AS INDICATED AND WEST DENIV I S / MA S.S .
CONFORMS TO THE ZONZAIG L A W.S _
OFi�/92A/ is cF, MASS.
DATE: � 10 12 SCAI-E:
'JOB NO. CLIENT.-
DA E i' PEG. LAND SURVEYOR I�R. f,��` ��•!%'%r SHEE 7' '�,�"
4'Pvc PIPE Cl EAN SAND
CONCR M1iV. P/rCV- CONCRETE
� ETE COVERS ya~ PER FT. COVER 4.
LIQUID 2" LAYER ,
.i'. LEVEL OF y8 - 31
PIPE NOS /250 c1ge o o, W o .WASHED STONE
P/TCt/ Y.'pER FT. SEPTIC
8 XT o ' _ 0 310
!. F. o WASHED STONE
$.pUTc67- o lk (i a
o W W PRECAST SEEPAGE
0
Lk O n PIT OR EQUIV.
o W
.� FT
t
GROUND WATER TABLE ���tH OFM'�1'9y
c
SECT/ON OF F RICHJA sD Gam,
SEWAGE DISPOSAL SYSTEM o'HEARN
NOT TO SCAL E ,p No. 694
INVERT ELEVATIONS
INVERT AT BUILDING FT. SANITON��'
INLET SEPTIC rAAK. FT. 501.L LOG
OUTLET . SEPTIC TANK FT. _ �P&SN of yq
/NL ET DISTRIBUTION BOX FT. DATE OF SOIL TEST � ssq
LA
OUTLET .D>STR/BUTIOtV BOX FT WITNESSED SY /Z•� / �/ ��� CHA
RJAMES� Sys
IAIL ET SEEPAGE PIT FT. PERCOLATION RATE G z M/N.//NCH o'HEARN
No. 27871.O
ELEVATION /S7fr.�'c p�
DESI GAI CRJTE): 'IA
NUMBER OF BEDROOMS �u13 50 SURd
GARBAGE DISPOSAL UNIT /y0n/F
TOTAL ESTI/APigTED FLAW -�'o0 _ GAi.IDAY
UMBER O . SEEPAGE PIT a L'LEi9/V n�Fv To Z�T �%2-,A,2,9/i�/
N F S � ,�%s
SIDE L E'A CHING AREA / SQ. FT. MASS.
�
BOTTOM LEACHING AREA /00 SQ. FT. An/D �FAVFL 7/'�%�.�r.�r
TOTAL LEACHING AREr SQ. FT. RICHARD J. M4EARN9R.L.S., R.S.
RESERVE LEACHING AREA 1 SCE.Fr. 19/ MAIN ST.
WEST DENNI 5 ,
Jos No. U.�= CL/ENT: (�TZoI v o
aq r E 616/7 7 T` OF Z