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HomeMy WebLinkAbout0185 OLD POST ROAD (CENT.) - Health 185 Old Post Road Centerville A= 209—052—003 N SMEAD No.2.153LOR UPC 12534 smaad.com • Made In USA �.CYC� ....L//7 .Fizz.. ...�.. THE COMMONWEALTH OF MASSACHUSETTS s� BOARD OF.1 HEALTH ..... .............. �i r 87 ApPrFatinn for UiipnnFal Works Tnnitrnr#inn Errant Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ....Lo. - -®C=v-� .. ex. ................ c - .............. ... lrC� ..LL = er .Address a •------------- ..... ._ '��. ................. •-••..._._........--------•....._.......--••------•---•-•---------.......--•-•••-•---------- Installer� •' Address Type of Building - Size Lot.. _ _®® .......Sq. feet Dwelling—No. of Bedrooms ..................................Expansion Attic ( ) Garbage Grinder ( ) pa., Other—Type of Building ............................ No. of persons.....................--.---. Showers (?.)---Cafeteria ( ) Other fixtures ....................... . . Design Flow--------..g V P P P Y Y � �. W .....--gallons per person per da Total dail flow.........., 0...............gallons. W Septic Tank—Liquid capacity.112 allons 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 ( ) Dosing tank 7— 1-9— 7/" a Percolation Test Results Performed by....... -------- -------------- •................. Date........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit.--.--.............. Depth to ground water........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit..--........--...... Depth to ground water........................ ;4 .................--------------------- .._._ ............--•Z....... O Description of Soil.................... �_ __.:.. ! '�� t�!- �r'- ' �-t _ _. �z�.� x z, V ..............................................•-----------------------------•-----.......-••--............------•---•-......--••-----•-•--••-•----•----------........-----•._.....--•---. ----------------------------------------------------------------------------------------------•---••----.----------------------•------•------------•---------------••--------•-•-......-••----•••.----- V 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 iITL U 5 of the State Sanitary Co e— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee 's ed by t board of health. l Sign - --. :/. - ........................................................... ace7E/x Application Approved By....._ � . !+_.. .._ /✓/%� !� -(� ' �� Date Application Disapproved for the following reasons:............................................................................................................... .........-•---•------------------------------•--•-----------....------------------.......--------....._..I....-•-----•--•-•-•-• ---•--•-----•-----•--•-----------•-•------••--•--------•----•-•--•..... QG Date Permit No.......................................................... Issued---&-�Zf -7•�•f....--------.....--- Date No..-• •-7� -- F�s...,t�t �............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .� ................... ... F................ .... tom_ -� Y. Appliration for Disposal Works Tonsirurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal: Sys 9m a - [ �" rbl I_ . ... . _....----____ ...... ........ ................. - ---- -------------• --- ._ _...."ca....&a_.5 .............................. � .0..... - .._..._._ _.._.l Y_:_�._.. .....�' • Address Installer Address dType of Building Size Lot... -------Sq. feet U Dwelling—No. of Bedrooms___________________________________________Expansion Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building ____________________________. of persons............. Showers (' — Cafeteria ( ) P4Other ures -------------------------------------------------------------------------------------------------------- ---- d allons per person per day. Total daily flow__________- W Design Flow--------- P P P Y Y gallons. 1:4 Septic Tank—Liquid capacity_____ :_ allons Length................ Width................ Diameter---------------- Depth................ Disposal;Trench—No..................... Width.................... Total Length............._...... Total leaching area....................sq. ft. Seepage Pit No......._............. Diameter.............:...... Depth below inleg................... Total leaching area..................sq. ft. z ; Other Distribution box ( ) Dosing tank ( ) O/V— '7- 7 7 Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water........................ (�. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •-•--- .._••----_--- - O Description of Soil-----••-•-•--•-••-•. �....--�-- ` ----- '" ------� .- - . ..-- v ------------------------------•- UW Nature of Repairs or Alterations—Answer when applicable P PP r.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 5 of the State Sanitary Co e— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be ied by F boo d; f health. - Signe .:•••= - ......................................... - f- �I ate Application Approved By...... ............ .... ...............7. ":. Date Application Disapproved for the following reasons:----•---------•---------•--••-----------•---•---------------------------------------•--••-• --•-----......-•--- Date PermitNo......................................................... Issued.............,=----------------------------------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF ALTH ............: ...........................oF......:.......... ..•• )ee%- 1....-.......__.................. �rrtifirair of f omplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ) or Pepaird ( ) by ' .........n.6_ 11.. a ----------- at •- c J has been installed in accordance with the provisions of T � 5J� The State Sanitary Code as described in the application,for'Disposal Works Construction Permit No. 7 �.--___________ dated........ 7___77......... THE ISSUANCE OF THIS CERTIFICATE SMALL NOT,11i CONSTRUED AS A GUARANTEE THAT. THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............. 'l.y Inspector $.` /..._ .......` -••••-•---• a, THE COMMONWEALTH OF ,MASSACHUSETTS '''''" BOARD O HEALTH .............0 / No.............. Fj ,. Disposal Works onotrudiun rrmit Perm'issioq ia,,hereby granted_--=----------------•-------------••-•------•-------•------•--....................-................................ ......... 3. to Constr t ) or Re .•r ) n . i idual �a Is sal S t .�, at Street as shown on the application for Disposal=VVorks Construction Permit q Dated ' � ` ...... ,.w;^ 2- 7 DATE--•_... .' Board of Health ---_---- FORM 1255 HOSES & WARREN, INC., PUBLISHERS PIE 6A5/I/ aQ r,q � rN<L,E /-,,4/Y?/L�� - ,3 2732 ' s�rlC 7",eJr✓K = 3-:�30 /-40 4?5 spa /50 SF ,e 15 = 375 6F'Ia f Fury• —66r7'a,t4 AV6-1 50 70r44. 5/GIJ .rI25 G PIS C� T�F2c r4mr / �2oP �N ':�'A- la- Iz I � � F� sut .� 74Sr 41ol_ ef YS I-'z 7-E'S? ,CG. 97 �-- To/ Fury rao. LoaA 4 RP& t S:.A&;o Q�'.a � � �iuJ s,V�f moo �INv /Av✓ SoPrk 94 75 45.0 � P�Bc Tix r pr r �'sm�tF E�cTtf�t�t E�r�b2 82.o GEtZTI>rtEt� pt..bT" PL./�l�.l uo u/�test FED F« 12 o .sc 7�� l d GA Y i o tit cc �- tiL �o 7l�T`l= _ +7/tq b-7 i GMRTtt=Y T"A-r TtaF-- �UV7�D(JT1�iJ Sttcv�.v�.! PLA�1 TZ�F"cRc►.1G t- T-jZ j=nc.l f oAA L_s-eG vl/MA TI-AG: 51 D E Ll► G= A wr-> SETtaACK RE-QuicemakiTS OF THE -TowU OV7 t= s A PPt�� vA'TG tZEGISt'I�..I:�D t_.AIJp 5u2vE.YoIzS TNtS Of At-1 tS E•_.tO-r r6ASFt> v4.t Act oSTFr�vi�.t.G o ArCASS. ttJ�t-E'�r��t•1 i 'Su�vt��{ TUC-. o �, rS 5►tc•wu� APPL-I ca ""V- / u c r r_e m t W& L >r LI Wi,:s _._ LOCATION SEWAGE PERMIT NO. 1rILLAGE CC, INSTA LLER'S NAME & aADDRESS i 7 c a -� 3 i '7 7S —t3 z._ B Uf'L D E R OR OWN/ER G` U !..-e DATE PERMIT ISSUED �- DATE COMPLIANCE ISSUED !oL tVk 711 ............ THE COMMONWEALTH OF MASSACHUSETTS BP ARD OF FIEALTH ._... .:. ..OF. ..................... Appliration for Biiivviial •Yorks umitrudiun rcprrmit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at 2 �_� �c� � " ..'l.�Q.0 _.....--. .............. Location•Address or Lot No. caner Add ess Installer - s Addie ?�} QQ�� Type of Building Size Lot__I_..1.j,-,?_.LJ.b...Sq.`fee�t Dwelling No. of Bedrooms....:.......... Expansion Attic ( ) Garbage Grinder -1 `4 Other—Type of BuildingY ______________ No. of. ersons__....._._.__:_ ........... Showers — Cafeteria W Other fixtures ---------------------------...____.__----- .._......_ . W Design Flow........ -_i_::0......................gallons per person p�r'day. Total daJ�Y Qow............. - -- .-•------ r lon� WSeptic Tank-Liquid capacitygallons Length. _.___ Width:__. _-_. _. Diameter................ DepthA0.. x. Disposal Trench-No.................... Width___._._.._.___.._.. Total Length_.....__:_..f__:... Total leaching area................ ft. 3 Seepage Pit No-------.,_._....._._ D meter_.._....Lo_.__ Depth below inlet_..._,.......... Total leaching ar ___ ... .....sq. ft. Z Other Distribution box (^� Dosingauk ) I a Percolation Test Results Performed by-----Ni A ._ ......._.°... Date___ �. . Test Pit No. 1....... _ _ minutes per inch Depth of Test Pit Depth to ground water..]1' _ %. (Z, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ x v :....._..... -- - ---- ,, O Description of Soil_. �P c �C�� <- h•1,�- ! �.......... - b c, •........------------------ ................... _..._ --------------•--W -__ . U ' Nature of+Repairs or Alterations—Answer hen applicable.._. �_. p,& a. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of L I L L; 5 of the State Sanitary Code—The undersigned further agrees not to place the system in -operation until a Cer icate of om e has been iss the bo f healtil> Signed.............. ............................ .. .:. i.......f..... .... �> Daye Application Approved By.................................. ....... :.vr,.?• f:`?.... . Date Application Disapproved for the following reasons:..........................................:.........................'__.._.._..__.___________................. ...................................•---...._..__......-•-••-------•-_._-•-•---._,..•----......-•-----._-..._....._..........._.._....__...---._............_...____---_____.------ - .._._....-•--- Date PermitNo.......................................................... Issued......:...:..................................-........... Date No...................... FEz........................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF FJEALTH T- 'O ................OF. . Xpliftration for Mqpviial Works C owitrartion rumit Application is hereby made for a Permit to ConstructRepair an Individual Sewage Disposal System at: ........ ...........LLII �LT t J_ ........................... ....... ............................... Location-Address or Lot No. A- :::(.I...............77 11..... Owner aAddress 0 "ZI(i C_ ............. 7T I ...................................................................7i W.................... .... . .......P��j LCE --- .......­* Installer Addrest....*------ ----------------- Type of Building Size Lot_11 ...Sq. feel/ U —No. of Bedrooms________________ Gart'a"g,e" Dwelling ..............5.....................Expansion Attic ( ) Grinder Other—Type of Building r.............................. No. of persons............................ Showers Cafeteria Otherfixtures ..................................................................................................................................................... Design Flow........VA....(D......................gallons per person p�r day. Total daily flow..................1-n-R. .........zallons. 'I ' 7 it C4 Septic Tank—Liquid*capacity100.0gallons Length.E)110 . Width... Diameter________________ DepthA�.I.d. Disposal Trench—No..................... Width...._.._ __._._____ Total Length._...._____.__.... Total leaching area............I........sq. f t. 7 Seepage Pit No........X........... Diameter_.._.._.10. Depth below inlet.....(,-.%.......... Total leaching ar sq. ft. Z n box O' k Other Distribution Dosing ta 0­4 ei I Percolation Test Results Performed by .... ............. Date... Test Pit No. I.....<Zrninutes per inch Depth of Test Pit... Depth to ground watr fT4 Test Pit No. 2................minutes per inch Depth of Test Pit.____.__...._.__.... Depth to ground water.-__.__..._.____._.._... 9 ..................................................I............................................... 0 Description of Soil. . ................... 0 �Pm. ............t.k.........VAE-OXD�A....!�k. ..?'� �4 .............................................................. ............................................................ ----------- --------*---------------- -------*........ ........**..........*----------------11-------- ................................................. ............................................................................. U Nature of Repairs or Alterations—Answer when applicable..,-P,----------------- ............7;�;�.... 77, ...................................................................F4�k.... ...........b�A... ......... ................. Agreement: The -undersigned agrees to install the'aforedescribed Individual Sewage Disposal System in accordance with the provisions of TAI TALZ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Complia ce has been issue� I the bo allh, 0 Signed....._.__. / ...................................................................... ........1..................... Date ApplicationApproved By................................... f. ............................................. .............. . Date Application Disapproved for the following reasons:..........................................................I..................................................... ........................................................................................................................................................................................................ Date Perm' it No......................................................... IssuedL....................................................... Due ------------ ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH , ........7 k)........OF.......... ........................................................................ Tprtifirate of Tomptiatta THIS IS TO CER&FY, That the Individua) Sewage Disposal System constructed w),or Repaired 170 Al by....... .................... .... ......................*.......­­------------- ------------"':......"....... ............................. Installer '?) ............... ............................ at.. L q, , "0'*- ....................................... .............. has been installed in accordance with the provisions of TITLE- 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No....... THE ISSUANCE OF THIS CERTIFICATE S14ALL NOT BEL'CO;' I STRUED AS GUARANTEE THAT THE SYSTEM WILLFUNCTION SATISF'AGTORY. PDATE........................4-A-25. ............................... Inspector.... .....x�o ................................. 4. ............. ..... etas ............................. a. ........ f_1 I . THE COMMONWEALTH OF MASSACHUSETTS BOARD-'20F A" HEALTH ................OF.�......................................................................................kwd 1-ftZA). �T�%( E/ 1 1 '�S r_7 r7 ..... _5bz�� No......................... FEE........................ Disposal Varks Tanstrurtion famit Permission is.hereby granted..........P P��f:�............................*-------------------------- ----------------- ............ to 'Construct ( Vl� or Repair (,,.Lan Individual Sew.age Disposal System.. at No.......Lv.�....1_?....... r,_-t:Z-I-, .............................................. . ......... ............................................................................ Street J as shown on the application for Disposal Works Construction Permit No7._S._-S.-'27Dated....�_4­6?1�� ........... ------------- ............... Board of healthDATE....... ...................... .............. U-0 CAT ION r � SEWAGE PERMIT NO. Zco r ---) oW/ 6-sir 0� 5 - -- IILLAGE I N S T A LCER'S NAME i ADDRESS —7? BUILDER OR OWNER DATE PERMIT ISSUED DA;T:'E CO�M.PLIANCE ISSUED k�O SECTION - SELVAGE {` -- uM -SEPTIC TANK - ' to LEACH"D"BOX - - _(D - _� TOP OF FDN, -S���-(MSL) "2"OF i/STO 42' WASHED STONE , \ ,l IN OUT• :: r Scr✓�c- IN OUT. I l ti `_.moo G I N.. SEPTIC TANK 'S5 / ELEV. ELEV. ELEV. Ele) CE V. riz. ELEV. E EV o WASHED.STONE �'. .. - TEST HOLE LOG TEST BY.rt.r( . t-1S�ya,�..t�,yi-{. .�• C.yw--t i..c,�--! lyao;l-1 . - W I TN ESS } T.`_i' �f rY' Z� es- _ DESIGN - BEDROOM HOUSE TEST DATE - � \ T.H. * 1 T.H. # 2 t Xc.i, ELEV.A ELEV. - `f PERC RATE G z- MIN/IN. DISPOSER DISPOSER 2-11 4� „ - FLOW RATE (GAL./DAY), SEPTIC TANK 4't-5 " (� REO'D•SEPTIC TANK SIZE d LEACH FACILITY �----- �,u�l•.� SIDE WALL `�-`i I •Z BOTTOM Ira rr¢/ c lg.'�. ( I c,) s "tg5 G/D.TOTAL 2r USE: �-�—'� LEACHING '�` ` _ WATER ENCOUNTERED - NOTES: (UNLESS OTHERWISE NOTED) f � I 1.DATUM(MSL)+TAKEN FROM____HY` !`� QUADRANGLE MAP �7 2.MUNICIPAL WATER I .____-_---____AVAILABLE Vil OF 1 ` 3.PIPE PITCH:44"PER FOOT / v 4.DESIGN LOADING FOR ALL PRE-CAST UNITS:AASHO- -44 C'y S.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES:(1)FT. ARNE H. C>—DISTANCE AS CERTIFIED - 6.PIPE JOINTS SHALL BE MADE WATERTIGHT OJALA y ��� 0( k4SS7 1 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. VIL STATE ENVIRONMENTAL CODE TITLE 5 . 3079 ti 'Z o ARNE SITE PLAN sJ, '$ p K. LOCUS: o T OJALA ,4v R26346 REG.P A ENGINEER I\9�`,�.rs�p tgaS4 REF: Lo -Z down Cape en�ineerin� PREPARED FOR: CIVIL ENGINEERS l . r�� Lam`Ste-I LAND SURVEYOR --------- -- f (EXISTING)------------- BOARD OF HEALTH REG.LANDSURVE R CONTOURS (PROPOSED)—O-0—O-0— APPROVED —DATE +'��`ST 9� � • SCALE i-G MA . �.CV i 8/23f S� DATE ` I. ,.