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HomeMy WebLinkAbout0022 QUISSET ROAD - Health (2) as Qu s � r�u., c�,� a� 1��� 4 Fimz No. ._._.... ' '` •$THE COMMONWEALTH OF MASSACHUSETTS s; BOAR® OF H EALT- .... O F... � �7re-•E••• ..`-.... Lam. ...................... p0ration for Diopotia1 Works Too,itrurtion Famit Application is hereby made for a Permit to Construct.{,,)"or Repair ( ) an Individual Sewage Disposal Locati ess \ �— o N. �'t-p p .... -- -------------•-•--....-•---------•--------•-•---------•--(--.....-------•---•--....-•-------..... Installer Address / dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.................I......_.. _Expansion Attic ( ) Garbage Grinder (/71� U '4 Other—Type of Building ....... No. of persons............................ Showers — Cafeteria p`' Other fixtures ............ W Design Flow............. -----------------------gallons per person per day. Total daily flow---------- ..................gallons. WSeptic Tank—Liquid capacit ...__._.._.gallons L�ngth................ Width---------------- Diameter................ Depth................ x Disposal Trench—No/._..�_ Width. ........ Total Length.................... Total leaching area___--__....__:_._...s . ft. Seepage Pit __..____..._ Diameter _ ___________ Depth below inlet.................... Total leaching area_?--.4_ ,. Z Other Distribution box ( ) Dosing tank a Percolation Test Res ul Performed by. Percolation Date__.__../-.�� _.._ . Test Pit No. 1.......�__minutes per inch Depth of Test Pit____1_f>.._... Depth to ground water..___.,C`� � LL, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Q+' -•-•••-•--••••--------------•--••-•-•---•••••••••...........--•---•--------••--•-••-•---••......•...--••-•---•---•-•........................................ 0 Description of Soil................------------------------------------------------------•---••------•----------------------------------------------------------------------••-••-••--•_.. U ••••-•-•--•-••••--•••••••----•---•-•-•---•-•••••-•----•--•.......••-•-••--•---••...............•••-•--••----•-•--••••-•--•-•-•--•---•-•---•••----••-................................................... ------------------------------------------------------•--------------------•-------------••--•••-•---•------••-•--•--•-----•-••---••----••---•••-•-•-••--••-•--••...-•-•-•............••............... 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 iI i'iZ 5 of the State Sanitary Code— The a rsigned further agrees not to place the syst in operation until a Certificate of Compliance has bee d y t b of health. Signed. ----------••--•- �._l_.(. .............. ---- Date ApplicationApproved By.............................•-•--••-•---•-••-•--••-•••---••-•••••-•••----•................•-•--- -•--•-•--------•-...................... Date Application Disapproved for the following reasons---------------------------------------------------------------•-------------•--•--------------------............ .............•---•••••--•••-•-----•--•••..._.._......................••--••-----......-••--•-•-•-•........................••...............................................-•........ --••....._.... Date PermitNo......................................................... Issued-....................................................... Date 1 r + No......................... Fxs............................. "THE COMMONWEALTH OF MASSACHUSETTS BOARD Off" HEALT t. A.00rtttijawfor Disposal Workii Tomitrurtion runfit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal system a Dee r . _... - --------------------------------------- �... ----------------..... Locatio dress -- No. t t Owner d Address/ r f a ✓ �°/ ... =: ? c,% :I_J.�� ..... ..................................................................................:............... ,LjInstaller Address QType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms....................:.......................Expansion Attic ( ) Garbage Grinder aOther —Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures .----•-------------------------•------------------•---••-•••---------................................ -----•. - --------- - W Design Flow............. ....................gallons per person per day. Total daily flow.........._.`'....._...............gallons. 1:4 Septic Tank—Liquid*capacity.. ........gallons � L gth................ Width................ Diameter................ Depth................ Disposal Trench—No. .............� Width 1.._ d.. .... Total Length.................... Total leaching area....................s9 ft. Seepage Pit No..................... Diameter_ ....G__.._ Depth below inlet.................... Total leaching area.-$--_. It.4. - Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by----------- _. f!`'j.. .��_._.. $ .�...._._.... Date...................................... Test Pit No. 1.......�c'._mmutes per inch Depth of Test Pit...... ......... Depth to ground water...... l��X Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ p+' •-••--•------••--------------------•-•--••-•--- ••••-•••---••-•....•--••----..............--•--••............................................................ 0 Description of Soil........................................................................................................................................................................ 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 TITLE 5 of the State Sanitary Code— The urArsigned further agrees not to place the s7 in operation until a Certificate of Compliance has been/i)svo,d y t b ��of health. Signed. t / � ---_-•--- Date ApplicationApproved By.................................................................................................. ........................................ Date Application Disapproved for the following reasons--------------------------•-•----------------------------------------------------•-----------------............._ .................................-...................................................................................................................................................................... Date PermitNo......................................................... Issued---------•--------- ............................... Dattee THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ - ....O F....... ............................................................................ �rr�ifirtt#e ,af f�u�t��itt�trr THIS IS TO CERTIFY, That the Vivid al Sewage Disposal System constructed ( ) or Repaired ( ) / ' °` by .. ...._.---- Install at.......... _......'5..7.061.r,r� ........................................................`'. � !-----•----------------------•-•-------- has been installed in accordance with the provisions of TIT �' j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......... ... dated____........................................... THE ISSUANCE F THIS CERTIFICATE SHALL NOT BE CONSTRUE® A GUARANTEE THAT THE SYSTEM WIL O U TION SATISFACTORY. DATE..I ".. ... ------------------------------------------------- Inspector --•- ----------......--------------...........-•--•----•------••-•--.....-- THE COMMONWEALTH OF MASSACHUSETTS BOARD 9f HEALTH ® :.:.......:.: O F......................................`.::?�-'C'.. ........_....................... .. ... No....................... .. FEE........................ Ropmttl 180 , '5 1gottatr ion rrmit Permission is hereby granted...................... ro* `-'fir.. 4 Y to Const uc ( ) or Repair ( an Individual swage.�isp ystern atNo. < .a. ........... °.................-!�-`-�-....-•----•---••--•................•-------------•. .............. Street as shown on the appli tion for Disposal Works Construction Permit No._ `�"g�"�•Dated.________...41711 5- -----------------------------------------------•-------------------------------------•---------------- -DATE Board of Health ' - FORM 1255 HOBBS & WARREN, INC., PUBLISHERS S/TE PL A N T YPICAL PROFILE SCALE — I� = 3�' �L, �;L, �� NOT TO SCALE 18"STD. LT. WGT C.I. MH COVER 4"C.I. PIPE 4"B1 T- FIBER PIPE TIGHT JOINTS FLOW LINE OUTLET LEVEL _� y O TO FIRST ✓DINT DWEL L ING o I 1--�- - p p C./. TEE C.1. TEE S �--� J `' STANDARD PRECAST �p a� -' CONCRETE 1ODO'GALLON SEPTIC TANK D/STRIBU TION BOX 8 TO BE INSTAL L ED ON LEVEL , STABLE BASE. SEPTIC TANK TO BE INSTALLED ON LEVEL , STABLE BASE L p T 38 � 2„- //8" TO //2" WAa"HED PEAS TONE LEACHING PIT ALL AROUND FREE OF IRONS, FINES AND DUST /N Pt ACE' BASE 70 BE LEVEL Jc_ BRICK 8 MORTAR COURES 3/4" TO I-I/2" WASHED CRUSHED AS REQUIRED TO BRING STONE s9 L L AROUND FREE OF COVER TO GRADE 24 C.I. MH COVER IRONS, FINES AND DUST /N PLACE. vJ o AND FRAME t - - -- 1�>>4-0 4 ___ - ' LEACHING PIT SEC TION-- /NC E"T-- 8, FLOW LINE - - - -. ti _ �\ p/pc 1, CONCRETE TO BE 4000 PSI 28 DAYS 6„ 2. REINFORCED WITH 6" x 6 N0. 6 GA. W.W.M. s 3. 2' AND 4' SECTIONS ARE AVAILABLE FOR GREATER DEPTH REQUIREMENTS. 9-f ;�. P ti E G A+y T r OPENING WITH 4-1/8" 4. NUMBER OF PITS REQUIRED ' OUTER DIAMETER 8 a, y, �ouG, tvoo GAL NOTE; EXCAVATE TO ELEVATION OR LOWER AS ��C_ ,r 9 n T t 4 -�A N K _ I-3/4 INS/DE DIAMETER �`-' 0 (conq� p pcw �1, - -- j�� REQUIRED TO REMOVE ALL LOAM AND CLAY BENEATH PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN GRAVEL TO DESIGNED GRADE . a ti'o 0 62 7- f, "L 41-0 „ .r. p }c)4j aAR v"ruL . P E t ro4.E+ ed KL,E�. MlN EFFECTIVE DIAMETER (NO T TO EXCEED 3 TIMES EFFEC T/VE DEP TH) WATER rA8L E ' 1 � ( t�,► c� :'J �' Er..IGOuA.1TEr2F_c'7 � , -' L©-7 7 �s a Q SOIL AND PERC. DATA GENERAL NOTES V- N PERC. RATE z MIN. /IN . NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. } t ? SEPTIC TANK, DISTRIBUTION BOX , LEACHING PITS TO BE STANDARD I t:5. aa` TEST BY: '� ::r ;�� D (uklM f. JA12vl11G!A. 4, ASyoG Itit6. ; PRECAST REINFORCED CONCRETE UNITS .; U 4f J A v t?� { ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITNESSED BY: 23 497 ' ;� �� TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE., TEST PIT GR. EL.: DATE'�_''i'�'-� MINIMUM REQUIREMENTS FOR THE SUBSUFACE DISPOSAL OF Q U s >� r� O .� l7 TEST PIT NO. i F 1-)41 TEST PIT NO, 2 4o SANITARY SEWAGE EFFECTIVE I JULY 1977. 0 0" ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE TO{9 6 c ,L. To p 1/ 5 J1��G7lL a' _ �_o•n�,acT L) aaaniEi�� 4' BOARD OF HEALTH. - CvAt2< A�� AT COMPLETION OF CONSTRUCTION , PRIOR TO BACKFILLING, THE Nt r;D• h A ru D �-� ---- BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. --- NA C-D. ho p PITCH ALL SEWER LINES 1/4" / FT. UNLESS INDICATED OTHERWISE. ?' Zc DESIGN DATA BEDROOMS 3 DISPOSAL EST TOTAL DAILY EFF. 2 2 o GALS. LEGEND --- SEPTIC TANK I " " GAL. SIDEWALL AREA z ' '' GAL./SO. FT BOTTOM AREA _ 1 GAL./SQ. FT. SEWAGE DISPOSAL SYSTEM O x DO EXISTING GRADE LEACHING REQUIRED It 2'2 y SQ.FT. ZONE 1 �v�oo FINISHED GRADE ACTUAL LEACHING AREA zv5•b �i SQ.FT. J FOR o W IJ kl A,, T C- 12- I D, o p INVERT ELEVATION L/ J� DOMESTIC WATER SOURCE T r____ _� „a�„ LO r,;c' u T W_ v PROPERTY P E R T Y LINE MytL� T Ic rrz t/ !L t. G t- A. r ti is,T PLAN REFERENCE: �- �- 4 �' C? -) 2— �,. a,.�b,r r+ G SCALE AS INDICATED DATE ----- MEAN HIGH WATER % - �s. y iR r r2.@ENCH MARK DATUM' Af MARSH �� ° �� '�, WM. M. WARWICK a ASSOCIATES 4 BOX 801 - NORTH FALMOUTH (�''- ...- !J t: t� Z� Is.JI"c A.1 O f.J — H � "Z/a. t� L? c G. i'�« , f' '�•��l���T��?' 02556 MASSACHUSET TS