The URL can be used to link to this page

Home My WebLink About0016 LOOMIS LANE - Health (2) 110 Lc�OrvGoo C.c� 23�- t � Fxs ...... ...... f + THE COMMONWEALTH OF MASSACHUSETT.S BOARD OF H ALTH 0 D� .... ......3.�..._..... ...........OF........ ._._ ��" -1.g- ............................ Appliratinn for Mynnttl Works Tonstrnr#inn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal atAT _ � _ ��rec ►S Atr. �ar-lTr�£�,�rLcF ....... ............j4ocation-Address..-^....^• .... or Lot N.... .....' ................. ... -- (l_BYE C i r�iri�� c ........................ ..............................................' --........•••'•••-••-..................... Owner Address A ` Installer Address dType of Building Size ,Lot.................... .....Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder-(-- Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ............................... .. ...... Design Flow.._....... .........................gallons per person per day. Total daily flow__._.......�j.-3�.....................gallons. WSeptic Tank—Liquid capacityL. 7..gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length................... Total leaching area....................sq. ft. Seepage Pit No.....!.............. Diameter.._...(r_.._.._.. Depth below inlet.•.e---•-•-----•. Total leaching area...�G7.....sq. ft. Z Other Distribution box 0C ) Dosing tank ( ) ~" Percolation Test Results Performed by.. 1'Pf ___ !�Pn....r G.A...............•........... Date....��................................ aTest Pit No. 1.....2........minutes per inch Depth of Test Pit.... )�....... Depth to ground water...._................ fT Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ "fi Description of Soil fi'1_ "l K .-••••-•--•-••--•-•••--••-••••-------------••--••-----•-•---•-••...... U ------------------------- --------------- --.................... 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 U 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 t board of healt . Signed----• •--•-----•---- ..-_•• •--.....................��................ _ Date ApplicationApproved By.......... . ..................•-•--•----••-----------•---•--•---•---•--......-- -•------ ------ Date Application Disapproved for the following reasons:............................................................. ---------•.....................................................•-----•---•-••••-........--•-•••.......-•-I••-•----•------•••-•---•---•-----••------•--•••---•------•-----•-•-----•---•••......-•--•.••••• Date PermitNo..........................-- .... ------•--.. Issued-....................................................... Date No.. :�..:. F$s....:-x ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H ALTH ......A+4. ....................OF..........:::....... _V r`?`-- .--1.` wS----------------------- Appliratiun for Dlupuual Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: tr 14 I.S, I Ate,F C �4-t�'t ti V11,(C � T cation Address ......• .•.•••.••......... or Lot N •••.•....... Loo Ownez Address ,,[tw `'7y° ------•--•--•-••...................... ..............................�. -• „!0 rf .... -._...... ................ Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms...... `.............::. ..........Expansion Attic-•F--)r Garbage Grinder 4 p,, Other-Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) rs'04 Other fiu es .._._... ------- --••------------------•--•------------------------------•-----------------------•-------•---•--•---•-.----------------.---------- W Design Flow....... sl _...... . ..gallons per person per day. Total daily flow.......... �....................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:.. _. Diameter........ .r......... Depth below inlet__:.' ......... Total leaching area...?A 7....sq. ft. Z Other Distributionbox (X) Dosing,tank ( ) j -� ''' Percolation Test Results Performed by.. ..p �! �'�....r"."'..6� ._..... Date... �fZ lr 1.4 Test Pit No. I......*2......minutes per inch Depth of Test Pit.....[11...... Depth to ground water....... ............. f=, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ '' • Qpl i .sFD Description of Soil.......... hit: ••--•......--•••-• ........ --------------------- -•-•-•--•- ..... --••• . •.. -- •---• •-----......--••-----.....----•-•. •-----......--•--........-•-----••-----•------..---••------•-------------------------------------=-----------------•--------------...•••••.......-•----•.....•••--------•------------•-•----•------•••...---------............----•-----•-••-•••----... VNature of Repairs or Alterations—Answer_,;when applicable.................:............................................................................. ....... --•--•..............•--.................----•-------...-----.. j Agreement: ¢ The undersigned agrees"fid-.install the'sforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIEE..:5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issue` t oard of healt Si ned. ... ---- •--.•............... ...... .. Application Approved B ,,-•� Date Date Application Disapproved for the following reasons:..........................................................................................................___ --.....---•---•-----------------•----..............-------------•---.....---.....------.........---------.-••----•--------------•-----------------------------------------.-------.--------••----------_ Date PermitNo..................... - -_.... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF `HEALTH .........................................OF;...,�. .... ... :..... (Irrtifirate of Tuntphatue THIS 1 0 CER IFY, That the Individual Sewage"Disposal System constructed ( ) or Repaired ( ) by................. ?(»�......�r! �o^.......................- .--- -..._.....________•--................--•--••-•--._....... ................... ._...._ - .._. Installer has been installed in accordance with the provisions of TITLE, 5 of _he State Sanitary Code as described in the application for Disposal Works Construction Permit No._......��_. .. �1. :. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL F NC ON SATISFACTORY. DATE.................. Z ............................•---.__._..__. Inspector......................•••..............-•••-•................--•-•-.................. I. ....° 4 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No ..........................................OF..................................................................................... FaB.... `...: . ]Risposal Works Tonotrurtion f rrutit Permission is hereby granted........ . ?r ay to Construct ( ) or Repair ( ) an Individual Sewage �osal System at No............. �°" 8 `; - - `'`fir;�C-�,...4.�1.......... �.t 'a �_�C!<...._.......... -............ Street as shown on the application for Disposal Works Construction Permit No� ...S) Dated.____.. 1a.1` ....... ..^ ` . Board of Health DATE....... ��.. .°....................................................... FORM 1255 A. M. SULKIN, INC.. BOSTON i , 'PLAN SC DB AL ._. I P; t I 1500 ' T 2.50Q, , tiff ND _ �, 1�rof1 l�- No '3C'A c }n I � ALL , CAPS NGlN.EERyN,G. ��"FlARB.�R �oR n t _ , _ NyANN�s , a2 a� fi. _ I:, �L AV OF L . A)Q E ER 4«.MA,.. FOR. .. . ; No:T.E: � � .-. � ��•�l7E�QE,KT 1?'.. Cfi;MoDN: oT2. j ' l &AS60 0Ad,' U,5.:C.Gr; Alb.e�fi f�,-,'.sCaiadnc//�'. on Ocfo6er //th; /993 Q17t/ c>a.r o ea i TE ST Pt r, TrA - Na tnJa.ter E7[P.,W i-c.a; ' P��N OFMAS n�rc,• R�fG _ :.. � } `. � I-1 o�� WILUAM s9�� i H. +v p f ? A�No. 8995�0 . i GISTS IONAk- Ire At A 8{ ` 24 y r ;�iTok, F FOUNDATION s„ CONCRETE COVER CONCRETE COVERS r� e e 4' CAST IRON 12 MAX. , • OR SCHEDULE 40 12"MAX. • P.V.C. PIPE 4"SCHEDULE 40 PV.C.(ONLY) ' PITCH 1/4"PER.FT. PIPE— MIN. LEACH PITCH 1/4 PER.FT. PIT PRECAST 0 0INVERT �o• �' • Q LEACHING EL•��-�• • ••. INVERT INVERT p . e•: PIT OR n'. SEPTIC TANK O DIST. W ' EQUIV. ° INVERT EL.,f...i�. . . . BOX ELSO...... _>_ ii"oo GAL. INVERT o; EL.S�,y INVERT wW J. 3/4"TO II/2 EL3R:Y. ww o ELfO•./.. cl U- WASHED w STONE 6'DIA. • (�— /�i DIA. 3'•'�' _ _ —1 yam_/_ PROFI LE OF No GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE /SQI L_ LOG 3•, W E SED BY : DATE TIME. .!a . . . . . . BOARD OF HEALTH `TEST HOLE I TEST HOLE 2 ENGINEER tEL-EV. .Q.: `�. . . . . ELEV. .. .. . . . . . . cV - DESIGN DATA NUMBER OF BEDROOMS TOTAL ESTIMATED FLOW .33.Q . . . . GALLONS/DAY BOTTOM LEACHING AREA ITR.�=7Y rSQ.FT. /PIT W E cJ S)9409 SIDE LEACHING AREA4Z90, =/lr X. SQ.FT./ PIT y)0.D 1�( GARBAGE DISPOSAL . !✓v. . . . 50% AREA INCREASE) A• (JU TOTAL LEACHING AREC��J-. . . . SQ.FT pt Sf �D . i PERCOLATION RATE .�. . . . . . MIN/INCH .N.O„WATER ENCOUNTERED LEACHING AREA PER PERCOLATION RATE fi SQ.FT. NUMBER OF LEACHING PITS . 04/,67 . . . . . . . APPROVED . . . . . . BOARD OF HEALTH DATE . . . AGENT OR INSPECTOR OF 10 Y +_Ipper Cape Engineering co. PETITIONER T Fern , Ave, E.r,