HomeMy WebLinkAbout0060 LANTERN LANE - Health t e-Kil i Louoe , /�ct �n S
r
i
i
i
I
0
j
i(
a I'
,�
I�
..
--- -
LOCATION SEWAGE PERMIT NO.
VILLAGE
(vNIs
I N S T A LLER'S NAME A ADDRESS
J"0 h n �7- 6 a v/'o
170, 13 6 3d E4 57'
S U I L D E R OR OWNER
Cos-Os 7sole91Vj-5
DATE PERMIT ISSUED Z3
DAT E COMPLIANCE ISSUED
N Fell
� 1�
13' 371?"
C = zC°
D= 29 ' 7"
�= 20
No.. _ '2� 13> Fxs.. -..•..... .........
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
-------TlvtJ.-..-......OF......�� 40f—' T% C
ApplirFativaa for UiupuuFal Works Tuaautrurtivaa ramit
Application is hereby made for a Permit to Construct (� or Repair ( ) an Individual Sewage Disposal
System at
..
.. • .....^_. /,�IIJ X. 4 ------------- -!--- .................................. ---•-----•-•-•--••-------•------•------...........-------
.. � �.... ...-.�..�a.on . Tells .... . plot . ./9rt� l y XV o
/ Own Addres`S /
a (/ � ........................ ..............•••--...................---........-----•......-----....._.... _--.....--_-•____
Installer Address
U Type o uildin . S feet
g / Size L'ot_�d�s_...._. q.
*-, Dwelling—No. of Bedrooms--------—/ ...................Expansion�ttic ( ) Garbage Grinder ( )
Other—Type T e of Building No. of ersons........................... Showers = Cafeteria
Pa YP g P ( ) ( )
a' Other fixtures .
W Design Flow............... g P P P Y Y � gallons.
..� _________________gallons per person per day. Total daily flow._..._.._.__.___.___......_.__._.____...._
04
W Septic Tank—Liquid ca.pacity���allons Length................ Width................ Diameter---------------- Depth................
x Disposal Trench—No/ ______________•----- Width..........e......... Total Length_......__. _-!.. Total leaching area•__`_--_L
sq. ft.
Seepage Pit No._......1..... .. Diameter.._.._l12_..... Depth below inlet._..._�0__....._....Total leaching area;l. . ft.
Z Other Distribution box (� Dosing tank ( '�J_' �v
Percolation Test Results Performed by...................�-` --/... ...__._..___....._..._._......... Date------- ...._.__...
Test Pit No. 1--_--.:�Y el
mutes per inch Depth of Test Pit....... .......... Depth to ground water_._____!I/6.....
tz, Test Pit No. 2...... __..minutes per inch Depth of Test Pit......f ........ Depth to ground water..._._.�d••-_--.
O �• t -_.... --•---•J .. 1. r
Descri tion of Soil-- ------D--Z �. i✓�..... •-_'(P ��r -�9l�---G'='�-----
c., T.. 4.-1__...
r
x ..... 6,00 l --- ,---./� // ..........................
U 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 TITL- 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operati9ij until a Certificate of Compliance has bee • ed y the board of liealt
Al
Signed ............................................._.. i"— a - 34S
. '-•---•......___••---------
' Date
Application pproved By......... ---- ` .......................................
Date
Application Disapproved for th following reasons----------------------•--------••----•--...--•'•---------------•-•-------------•--••-------......-.............
------------------------------------------------------------
•------------
•------------
.-------------
----------------------------------
-------
=--------------------------------------------------
Date
Permit No5- -3-3----------•----------- Issued-------•---- --
Date
,r
FnB 1�210...........
No.........................I I
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.......OF............. .................. ..............................
Allpfiratif4i lor Bilivillial luorks, Tv'mitrartion Prrmit
Application is hereby made for a Permit to Construct (N or Repair an Individual Sewage Disposal
System at:
............................................................
............... ......................I...............?_
Ires
r 1),......... ..... 0..... ....................... . . ....................
5
Own Ad dress
-
.. . ... .......... 7 ......... ... . ......................................... ........
Installer
------------------Address
< Type o Building
Size Lot./440-:��.....Sq. feet
U Garbage Grinder
Dwelling—No. of Bedrooms........ ....................Expansion Attic
.4
PL4 Other—Type of Building ............................. No. of persons........f................ Showers Cafeteria
04 Other fix es
............................................................................................... . -------*------------------
--------M" -.Olons.
. ...................
Design Flow.......... .........gallons per person per day. Total daily flow.
04 Septic Tank—Liquid capacity W allons Length................ Width__....._----____ Diameter-__- -- Depth................
Disposal Trench—N ---- Width.........�e......... Total Length....,..,..' -,,,.... Total leaching area'.%-------# sq. ft...,
- ------------
.Seepage Pit No---------- Diameter�._./P...... Depth below inlet..... .........Total leaching areaft.
Z
Other Distribution box (X) Dosing tank o
Percolation Test Results Performed by.............:......Z..Z... Date 7
.. .. .............
o I Results
Test Pit No. ...... per inch- Depth of test Pit--__._Zi o ground', a... r--------- ......
Test Pit No. 2...... minutes per inch Depth of Test ..... Depth to ground'water-------�,V ..... .
. . ......... 4........... --------
We
0 Deyn�tion of: Soil_ /.......0..
sc ------
Jov4!�� �............J..Q�............. ...... . ...
....................................................................................................
U 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operati,pi until a Certificate of Compliance has bee 41�ue by the board of health.
Signed. ......................................................................... e.....
Date
.
6�Application�Approved� By........ ............. ............ ...I............................................................
-------------+
Date
Application Disapproved for t following reasons:...............................................................................................................
........................................................................................................................................................................................................
Date
Permit No..... ------------------------- Issued-............*..n...Z....=g..5:...............
DaTe'
THE COMMONWEALTH OF MASSACHUSETTS
BOARD 0174HEALTH
....OF.....................................................................................
(Irrtifirate of (911mlifiattrr
THIS IS TO CERTIFY, That the jlaiviftal Sewage Disposal'System constructeAk ) or Repaired
?...........................................
by-__'__-------------------U
y---------------------------------.....................5�E--- ----Installer.............................................
at....- .............. ....... .. ......................................................................................................
o�has been installed in accordance with the provisions �ITLE, 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit NoV_S-:!...&.t IS............... d at e d-f—-!Tn.-a..R!t.$?s.................... . .
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE....._..... ...... ...................................... ,Inspector..... ..... . ....... .. ......................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD/)DF HEALTH
...........��i 0 F.. .................................
FiC.-O.................
Permissionis hereby granted...............................................................................................................................................
to Constr or Repair n Indiviqual Sewage Disposal System
atNo.....•U4........ ........... -----LA-VLk.........................................................................................................
Street
. d ... ....
as shown on the application for Disposal Works Construction Permit ...... DateA--a-- ----------------
............... ----lb..(-----.......................................................
..toard of Health
DATE.......................................................................--------
FORM 1255 A. M. SULKIN, INC.. BOSTOW"
SHEET i—OF z SHEETS
' v
` ` P
— . 42
4&3ol
/ E
S3.S
51.o
�2
23� si S �a 3�t
TpPD)cG.$. 1 .
Ems= sore s / '
IiA�Sun� i t
�'91v S/Z 50./
SEPTIC SV3T6v') i ; {
/ aNSTALLEO IN,! CQ; t�
L WITH TITLEr'
Ma `aNAAENTAL C&)
3s25. IWWR 307 TOWN R-"2 +U.LATI,.NS
SEWAGE DESIGN PLAN
- -- -_ LOCATION
SCALE l��'.2D.�f DATE
PLAN REFERENCE 440.7.�f'Zi. V e- � .
LAND SURVEYOR CIVIL ENGINEER
.S.
PETITIONER: , OF s LN°FM4
THOM . . .. . . . : . .. . . .. .. .. ......... ,�� THOAAA j s
KE E 17WO414S E, KELLEY o K N
No . o ENGINEER.— SURVEYOR
� `� 346 LONG POND DRIVE 9 ls-r
AL LANos SOUTH YARMOUTH, MASS. r
�'02664 ONALVa�
�� _. ._._�_�• �__� � � -SHEET"` 2 OF z. SHEETS
<.
TOP OF FOUNDATION
4"CAST IRON 12'
OR SCHEDULE 40 4"SCHEDULE 40 P.V.C.(ONLY) -.
P.V.C. PIPE PIPE- MINIMUM LEACH CIRCULAR
PITCH 1/4PER. PITCH 1/¢PER.FT. PIT PRECAST
°'e Q LEACHING
o'� NVERT INVERT INVERT W PIT
50 6
DI ST.
EL.....r . ... SEPTIC TANK
s•. EL..t`�?r Sill BOX ELL+z..
INVERT A
.. GAL. INVERT ^' �;• T'ww � };; 3/4"TO)V2�
EL.SQti .. EL� INVERT
w WASHED
-" w .*'= STONE
5-
Id MINIMUM �Z ---► --WDIA.
A5 olA
'. 20' MINIMUM
GROUND WATER TABLE
PROFI LE OF* �{
. SEWAGE DISPOSAL- SYSTEM —
NO—SCALE -------.
S IL LOG WITNESS D BY-.'
/ ; �p�ie)ts. BOARD OF HEALTH
DATE .. �� B TI M E./d . . .. ..
TEST HOLE I TEST HOLE 2 ., LGL ; . . ENGINEER
ELEV.. .-574. . . ELEV. .4` O _ _ , ,/ _
7m
DESIGN DATA : '
�/3 �iL SvgSa�L r
NUMBER OF BEDROOMS' . . _ .
TOTAL ESTIMATED FLOW GALLONS/DAY
G �sv GAA VVe-
2 .O� �cf'�,�) BOTTOM LEACHING AREA !.(�: �. SQ.FT. /PIT
14lvv.5)4A,0 SIDE LEACHING AREA . �?'�~' . SQ.FT/ PIT
Mlgt ►(;4K� ���, C42'0, GARBAGE .DISPOSAL . . .'(50 % AREA INCREASE)
TOTAL LEACHING AREA . • SQ.FT
JO� _ PERCOLATION RATE . . . . .7sli4-0. . . . MIN'/INCH-
//���� — Q�/ LEACHING AREA PER PERCOLATION RATE�( /?./O SQ.FT.
.!.Y.PWATER ENCOUNTERED
NUMBER OF LEACHING PITS . .A
APPROVED . .. : . . . . . . BOARD OF HEALTH ' ' ' ' 7' T" '1" ' '�'� 7 i9l�� '
DATE. . . . CIVIL ENGINEER
AGENT OR INSPECTOR
PETITIONER ���aH oFMgs
C / THOMA G
. � �� .� �C �S - - U LE� tin
• �� p�� ��� THOM E.AS KELLEY
. • l Niao �
P� ENGINEER— SURVEYOR -o i;
346 LONG POND DRIVE 90 ST��
SOUTH YARMOUTH MASSY BONA
02664