Loading...
HomeMy WebLinkAbout0619 FALMOUTH ROAD/RTE 28 - Health b!R �nAn k/, µ�un;J 0771 � / 33 .�,#,�-7/-/.3 .� z d /v r) LOC TION SEVACE PERMIT NO. V I L L A C E INST LER'S NAME & ADDRES 1,cJ RCP• bo ® U I L R OR OWNER DATE PERMIT ISSUED � DAT E COtiPLIANCE ISSUED O F w 0 No...IY-30 Y 4 Fmc...., ........ THE COMMONWEALTH OF MASSACHUSETTS BOA C,JF HEALTH Appliratilau for Dbipvii al Workii Tatudrurt au Frrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ........G..�! ... .�. ...�.,C�. ................................... .......�G. .-•------•------•-•----•-----•-. -- -... c ion.Addre s ��jy Q or Lot .. t✓ � y� Z'+�(+-'�"•r ...._._ C-.-Q..... .........lQa � ✓ � � -,/ ._ . //.� Owner Address alJ l 1, ...-- . -------_�,...�2....................... ..1�,2 ..-- ------�J �,t.2-------, �tJ-....... .._! c40(o.. , Installer Address d Type of Building Size Lot../ _ erll..Sq. feet v Dwelling—No. of Bedrooms.......................................Expansion Attic (&--f Garbage Grinder ( ) 04 Other—Type of Building �,,� - No. of persons...._S'.................. Showers ( ) — Cafeteria ( ) Pa Other fixtures --------------------------------------------•--•- w Design Flow.....//A!............................gallons per person p y day. Total daily flow........3�r✓......................gallons. WSeptic Tank—Liquid'capacity,/&"...gallons Length___, ,....... Width.__...y--___ Diameter................ Depth....- ..... x Disposal Trench—No..'.0............. Width.................... Total Length............. Total leaching area.._..._.._.._.._____s . ft. Seepage Pit No....� _r ............. Diameter _... Depth below inlet......La.___..._. Total leaching area.._... . .... ft. Z Other Distribution box ( ) DosinVI& `-' Percolation Test Results Performed b .-. eN in tt li-Date d� Test Pit No. 1_Wit._`j„'_minutes per inch Depth of Test Pit.................... Depth to ground water........................ G�, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 .......... •--------•... ...-•---••--•----•--•---•.................................• ----........ A ,Q Description of Soil - -.......... -�!'4.....---- O w ---------------------- - !7 , .&.�- ---------a�... .....-................................................................... UNature of Repairs or Alterations—Answer when applicable............................................................................................... -------------------•---------------••----------------------•----------------•-------.....---.......-----•------•--------------------------------------------------------------------•---•--------•------ Agreement: T e indersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the ov' io is of T TIE 5 of the S Sanitary Code— The undersigned further agrees not to place the system in o rat' until > t ance has n is d by the board dk lie lth. Signe - G DatS� Appl' ati A r e By--•-•-• ---------------------------------- -t-f--------•--- Date App i tion Disapproved for the following reasons:---•----••--•----•----------------•----•--------•-------•--------•---........................................ .....••••-•--•--••--•----....----•-•--•--•••-----•-•-••----••-•-------------•-----•......--•--••------------•-•------•-•----••---•----- ............................................................... Date PermitNo......................................................... Issued_....................................................... Date No.......................... FEs.............................. THE COMMONWEALTH OF MASSACHUSETTS HEALTH BOARD OF ....................... ...........OF...........-....-...................... Applirtttiaatt for Uiipuiittl Works Tom1rttrtiaatt rrmi# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .. ........__ _.......... .......... .......• .. -- - ----•-- Location-Address or Lot No. .................................................................................................. ._........•--------•--.........._..-•---......_................................................... W Owner Address a ----------••----------------------------------..................................... ......--------------•----•--••--^---•----•--••-•-----.......---------..................•........ Installer Address UType of Building Size Lot............................Sq. feet �-, Dwelling—No. of Bedrooms............................. a ................Expansion Attic ( ) Garbage Grinder ( ) ` 4 Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( } d Other fixtures W Design Flow.....................i......................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.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) W Percolation Test Results Performed bY.......................................................................... Date..................................... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 4A Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water..................... a ••-••-•---••----•-......................................................................................................... --.........---•--•- Description of Soil .................... . ----------------•-•-------------------- x c, -••-•-••-••--••-•••••-------•--••-----•--•--•••-•....•---• •----- w U Nature of Repairs or Alterations—Answer when applicable._.............................................................................................. -----------•----------------•------------------------------•---•------------------...-----••------•---------•---------------------------------------------............................................. Agreement: 21 e:undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the rov'sio 2is of TITIE.. 5 of the r e Sanitary Code— The undersigned further agrees not to place the system in o erat unti ca f` =C ance has been issued by the board of health. { - _} Si ned-•-•---•--•----•----------------•-----•-----•------•-•-----•--•-•---•--•--••••-•.-•-•• ---•--•-••••....._-----•..---•-- r Da APP cati A r e BY •----- ' '" •- Ap i tion Disapproved for the f ollowirg reasons---------------------------------------------------------------•---••. Dat - •--••-••--•---••••••---•------•-••---••---•-••--•---••-•-••---•-----•-•-•-------•---------•••••---•---•--------•••-•--•-----•-•--•-•--- -•--•---••--•--•---•-•-•-••----•---=---•------•••••-=---....._. I Date, PermitNo......................................................... Issued-..............................................= ..... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................OF.. . :� � ...................................... L �rr�i�artt� aaf �aant�littttr>e THI IS O CERTIAY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by........ p..t _1.......4�--ss''�.-L--------------------- ----- Installer , at U 1. = ------------ '-.... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Coe as described in the application for Disposal Works Construction Permit No.___,gq_"_` d_V............... Idated_...JI,t` ._PH THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE T THE SYSTEM WIL .FUNgTION SATISFACTORY. DATE.......... .Y....__. .._ . • Inspector. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ►�© ..........................................d/ OF... s9.C�i(�✓rlrZ C�_..r�..........-................. No.. - .. :... FEE. :$................ i �taa ttl rhai Tomitr diaatt ,°tutu Permission is hereby granted.... --1rA.d 1e l... r. Jtd•4.j-------•---------------•.................................................. to Construct ( Lor Repair ( ) atn Individual Sewage Disposal System atNo........./ 0-•..........----•••••. - Street as shown on the application for Disposal Works Construction Permit No..................... Board of Health DATE......... .. FORM 1255 A. M. SULKIN, INC., BOSTON Tr Hwyper S 2-0 00 r DEC\ `01 Eq r 4 >� i✓ y F . Z�, nq E• ; r 4 x w y P /o o ►�✓►:O T H s 7 � 9s9 9� ALB 0 (o E No.40951 V - �yyG Yk A90�FC15Ta�uwQ `!C- 38 , Fs � CONAL ,z.3 k y � EXISTING SPOT' ELEVATION b„0 CERTIFIED . PLOT : Pl::A`N ,y `�y ltTZ.: roc a EXISTING CONTOUR --- 04 s w w 5 7T l 7RaVTE Z8~' ��. Z7 S36 l� ROBfRT. G� FINISHED SPOT ELEVATION Q BRUCE: ' /'�. 11/f�l S FINISHED. CONTOUR 0--- y ...�.�...:.�: ELDRfd`Q 'N , APPROVED, bOARD OF HEALTH f x sY �pW r , z ` A< A. DATE _AGENT N� sv���� '�,� BCALE+ /�r:,�bi DATt� -.... L RED@E CGx_ ENQ/NEER/NQ l C41ENT ° " I CERTIFY .'THAT y.TI�IE '` KW, EOISTERE RE013TEAE0` d :l' 9UILDI.NO-; .`BHOIMN .'ON . TN13 Jbs NO.� 4r C1Vil; D CONFORMS TO THE YONINS l.Xtl1►!� r '°: ENGINEER U' .+ VEYO OR.6Y.+ l ;A OF; -BA wee ' mAS 712 MAIN STREET CH 8Y+ ` R,;4 H YA NON I A S+;M S 8 _ '/�j3 ,, ayF,, SHEY,�.L. �' �DAE; RES:, LAND:'SURVEYOR:: k NOTE /F E/TNGR TIDE SEPTJC TANK OR LE/¢Ci,�IiYG P/T ARe MORE 7-NA/V /2"BE40AV. !D PT.M/�/ .' IRAOE� A 24'D/AM ETER GoiyCR.�TE �Oi�ER s SNALL BE .®.40&4jYT TO SMAOE.( .AN ,EXTRA q"PYC Pi i A COv C RON R E h' A ST / !i .S L L CONC1iCT I Y /�A DE USED W. P/TCN I_ /F/N DRI VEyi/A Y . EC 4.� � CODERS ► s� t r F /a G IC CO R �rAOE E �fi I• ,�— CLEAN SANG - - Ll494I1D LEVEL 4"'CAST 2*LAYER t .IRON P/PE. .. �pC7O • o.v P '� QF Ma -J18" d; M/JV.PITGN G11L. • • • • s • •• • o °4o WASHFO 570 E SEPTIC TANK DIST , , , • . . . e . • ,•e , f • / + w I •1EFFEL'T 7VGr r r • ` 3 4 - j /�2 r • • pEPTi/ • • • ♦ o WA5)lED STONE , - �./3 n . e. , . • • • • • • • . v •�v PRECAST SE EPA GC 1AIMC �."LEYAT/OLVS �'T G�t./� ��7 y 4.90 c,.aL��sr a ..� . • • • • • . • : o cL 9 �/T OR E4U/V. /NYERT AT'OIJILD/NG FT' �7 D/AM. J O OSO C+ h,VX.&T SEPTIC T.4/VK .F9.910 FT, L le- FI O/i4M. �) C(SEE 7ylBlJLAT)ON�. Ov7LET SEPT/G TANK . .98.8 - SECTIO DJSTR/BIJT/ON BOX 98.3 F f /N OF ` GRO[!NO H�fITER TitBLE D/STRIB/JT/ON BQX FT /NLFT LEACN1'V42 4421/T FT .SEAVAOR O/SA205A L 5 STEM TA4VL.AT/0/V I LEACHI"..G .P/T .,SCALE : %" _ /=o"- Al A, ` ` ArT. DAWATH CAITAFM1A O/rfEJvs/aw $ 4 f'T. I: NLI/MBER.OF BEDR04OMS 3 GL+Re.4GE'D/SQOSA�4/oV/r. A(Ll n/0 SOIL LOG, TOTAL E3T/MATED =LO*V 3 3 0GAt.�DAs' DSO/L TEST lid/ SOIL Tl�STgdE2 SOIL TfsT � jkUMBER OF 4AfACN/Nl P/TS�_ f`ELEY /t?/6 �ELFY, pATE OF SO/L TEST S/O�LOCH/NG PER.PIT /s/ S4% a —3 RESULTS hI/TNESSED BY � .:90T JA4CH/NG R PIT r73 TOM PE PERCOL/4T/ON RRT6t / M/ JNCH t LOSS Ld<r:yt f� # jv' ;TOTAL LEACH//YG AREASQ. FT. 5 u 3s oiL FERGOLi4T/ON RATE 1�2 ?�'` 'r MIN.f lNCN RESERVE 1-E4CNimer AREA �¢ SQ. FT. z'v U. s, r✓��. Lv7 Gc a?356 A ?uc1Te 2d� 4 y �1H �41. S ��•;f: RO$ctZ7 c�;,'t J�Q• qS'/O � ,�/ � r �. r vELDREtDG ALBE1 f MORSE 01-PREASEENG// "WING CZt hVC. pNo.113951�0� EL. �r96 7t2 MAIN .9-r, NYANN/S, MASS. NaCroTo[//YE.t<<YYi4TEM E/VC'OUNTfREO ON I. (�_ OUNO:'LVA:TE�P AT ELEV D.� JOB NO. SHEET z.OP. 2