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Home My WebLink About0040 ROSEMARY LANE - Health (2) Gam► . o i, , /o R ►JU0 .. r o....---- -••--•.....-. F$a........ .. � .�. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH t h..e Appliratiun for Di, paiial Worko Tonstrurtiun Ilrrmit Application is hereby made for a Permit to Construct (tor Repair ( ) an Individual Sewage Disposal System at: 00. .........: t. :z�........................................................... ....... S,G:� .. locationAddress .... .. 1 S_... \�... .............................................. . n • i , t_ Address a . c. �`-------------------------------------- •-/ �... 5 .. e..................................... Installer Address Type of Building Size Lot... lt. .�L.....Sq. feet .. Dwelling—No. of Bedrooms......................................Expansion.Attic ( ) Garbage Grinder ( ) 04 Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ......................:......... . ....••--••..................... W Design Flow.......... U........................gallons per �r da+y. Total daily fl9w.:.:. 3 .........-----........gallons. WSeptic Tank—Liquid capacity/U gallon Length... ..:�.`.. Width;...11P Diameter. Depth...�'l." x Disposal Trench—No..................... Width.................... Total Length..................... Total leaching area....................sq. ft. 3 Seepage Pit No.....(?l .....Diameter........ZQ-..___ Depth below inlet........&._-...... Total leaching area2-(.ofs,its1.sq. ft. Z Other Distribution box (✓f Dosing tank aPercolation Test Results Performed by..:. ...fo-^^ .................... Date........1.!'. . .�... Test Pit No. 1....�Y...minutes per inch Depth,of Test Pit.../.5�....... Depth to ground water..... 44 Test Pit No. 2................In' es der Inch Depth of TestlPit....�1� !._.... Depth to ground water...._ x '�....: t CIA...j —3�"'.t.5s�.'.' ��.... O De i 'o of Soil... !M2�.,...rro. c�. •. . •--- .."7 z....s � r._ ...tY`tA.So.. W --•-•..._...•---••.............•.. -••--•--•••......-•••- ----............T ....... ---------------- able ...._......................... 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 LITI U 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee ''ssu d by the board of health. j 24i1-`j2 Signed....._.. = - ..... .................... ....... .............. l Da a A lication Approved B ......._._.. 'r'1...... `J�7 Date Application Disapproved for the following reasons:.............................................................................................................. , ......................•----......-----•--•-•-•--...........-•-----•-•-•-•----................--•-•---•---.•----........_.._...-----•---•-...-•-•-•••--....................--•--••.......................: Date PermitNo.. _....:`..1........................_ Issued..........-...................................:...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ((�� V � ......-••••-.....•••- Appliratiun for Disposal Works Tonstrurtiun tlermit Application is hereby made for a Permit to Construct (rf)' or Repair ( ) an Individual Sewage Disposal System at__.. - • II ...... .............••.... . ....... ..... ..... .....0 t Location-Address , j It, or L•of No ��r�, tom, Y\,Ai�� ej . '��I1,r,r \S #,A •.fit r.IGk ..................................................Address ..................•-.................. ............... = .. .------.............................._ ,�....�..........�..r...... �s l -. ............................:....... � Installer Address Type of Building Size Lot.... �;.�..� .....-S feet a Dwelling—No. of Bedrooms.......... ...........................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building .........:.................. No. of persons............................ Showers ( ) — Cafeteria ( ) QOther fixtures .....................................•.......'......_...._..- --•--•----•-------------------- Desi Flow..........._/U . per-person—per day. W gn �. .- •- -------------gallons per person per day. Total daily flow...........................................-gallons. W Septic Tank—Liquid' capacity/.*' �2gallons Length...L_2..�.... Width_._g Ff v._ Diameter_---- "'. Depth..5---2.. F x Disposal Trench—No................... Width.................... Total Length.................... Total leaching area............... ...sq. ft. 3 Seepage Pit No.... ._:j......... Diameter........ .... Depth below inlet........L....... Total leaching area.VA?:...1...sq. ft. Z Other Distribution box (✓) Dosing tank ~" Percolation Test Results Performed by....�_1;5 ii :. :........•__.........• Date._.....!':.Z � :..�.-.---. ..... ............... .a Test Pit No. I....!__Z....minutes per inch Depth of Test Pit... `� ..._- Depth to ground water...__..:: h ? G4 Test Pit No. 2.....L Z`....minutes per inch Depth of Test,Pit....` U-��... Depth to ground 1 �� .. w t , . �, r ��c. -.�,� � ? `.....::.�...;__,3t..::....i---��.....:'...� Ic�c�►.� O Description of Soil... rf?�.... .r. ....................................................... �►�+ 1•� " Z d - 3�'' "7 z, S ,�L�aa' �Q" -- rC9'`......C�PA�.� n� U -----•......-•.........................•--••-----....------•-•-------...........---------••- =............................................................. W r r 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 undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health., p Signed - .......°"`.... ...: ......-•......... ..........................9 � /Date 1 Application Approved By-•-•-.. �!}L ........I........ •-••--..--•-•• X -Date__.. .......... Application Disapproved for the following reasons:............•----.........----.......--------------•--•----...----------....---•--..........._.............._.. ...................................•----......._.............----.....--••--.......----^--•--...--........---...---................................. •..._.................. • ...---...... Date . PermitNo.................•---......----.......................... Issued......................................................_ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH t.,-) j of I..;-,�:..,-\ -,� d IF— .......................................... ............................................................... (fa if irate of Tuutpltanve THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.......... ��........-----•....... ... ........•-••---.....................•. ........... .-•--- •--•--....................---......................... �.�T'1�T� Installer ) �`'_ at. ' `�_...... -----•-• ..... --••....•-•-••-••-......�.. .. has been installed in accordance with the provisioiisyof TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......�5 ' 1.......�L........ dated....� � ...................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................. �!............... .� 7 Inspector............................................................._ ................. _.._..... ....� _ owf.. ,.__...___,._._.. .,.Y..� .._...,_ ...,.... ,.....M .... .. _.., ..V3. . _-_- _--.._ Lj / — 11 THE COMMONWEALTH OF MASSACHUSETTS ! BOARD OF HEALTH �rl ................. ...... .........oF.. C,y r�)a:, l y Now. ..... ... .. ---- ........................................... Fn.. --•-•- Disposal. Works Tunstrurtiun f rrmit Permission is hereby granted......... �C ........................... to Construct ( ) or Repair ( �) an Individual Sewage Disposal System at No....L Q.!------..?_/...............t !))a....-.-•-�:^--.(.�` ... _j Street — as shown on the application for Disposal Works Construction Permit No..................... Dated...... '. . DATE. 1..C.._ ' Board of Health .... 2 fP - SECTION - SEWAGE 1JorE: a w cH MAtz_K- EL. 42--S } Top OF r._.B @ S.E. co2wEp. LoT 1 = I�oo' Sou'Ttl of y I -SEPTIC TANK - 5 ' - "D"BOX - 0 -_LEACH TOP OF FDN \ I ` \�/ -49 c—- /] (MSL)s 2"OF 1/8TO Vz" Q ( / WASHEDSTONE IN• - OUT- IN• OUT' IN• / \� , !J,"`• �� K� �"I q SEPTIC t\ �'� / ��a <, p L. CST Z u TANK G ELEV. ELEV. ELEV. ELEV. //�` 3 ELEV. ELEV. ELEV. ) 2 {0, �O 2._ OFVa"-1Vz" 1 Q WASHEDSTONE 6- 0 L o T TEST HOLE LOG TEST BY �•FQ-1\bO..nF��.#}=2 J %_(eL7`�I��•L) �E#'(�,.IERI I I'�1`f�(� - �� ` DP! TEST DATE' WITNESS BEDROOM HOUSE DESIGN T.H. # 1 T.H. # 2 20 3 � ELEV. + ELEV.4<,b T N'NO PERC RATE � 2 MIN/IN: DISPOSER DISPOSER. 3G� S•o Ux L 3rl FLOW RATE 330 (GAL./DAY). 330 4 3 SEPTIC TANK 330 x a4 95(IS)= p�, N GL I REQ'D SEPTIC TANK SIZE 1 000 I EMI M _ ) �``;'. \°`� MAD. LEACH FACILITY ) l N� {l7 SIDE WALL ' A_ ` 0_ (2.5) _ G/D. BOTTOM o z ( 4,t> ) s7 L G/D. )56 USE: ENE•_ LEACHING _�rl NO WATER ENCOUNTERED NOTES: (UNLESS OTHERWISE NOTED) 1.DATUM(MSL)+TAKEN FROM___.H YA-NN_1$ ..........GUADRANGLE MAPOF 2.2.MUNICIPAL WATER � �_ ___________________ AVAILABLE - y'•� # 3.PIPE PITCH:44"PER FOOT 4.DESIGN LOADING FOR ALL PRE-CAST UNITS: AASHO- /'r 44 ARNE DISTANCE AS CERTIFIED 5.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT. pp� OJq�q SEWAGE 6.PIPE JOINTS SHALL BE MADE WATER TIGHT to CIVIL y 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. NO. 79,1 STATE ENVIRONMENTAL CODE TITLE 5 / �� OF �ss\ SIT PLAN LOCUS: o r o ARNE pt o H REG. L ENGINEER . OJALA L-0# 63 REF: d~ crape efgi*aeefl g ��J� I$ EF .• �' PREPARED FOR: V"fi ' 1 IJ O CIVIL ENGINEERS tLa�• ` LAND SURVEYORS ----- ---- _ BOARD OF HEALTH REG.LAND SURVEYOR. (EXISTING ) -----• BAD'-N5'T'RC3LE�MA Y ..YA SCALEI CONTOURS 'g� 3 3 - I62 __ (PROPOSED)—O��—O— APPROVED DATE DATE