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HomeMy WebLinkAbout0004 MAPLE WAY - Health Maple Way yannis 246- 148 I_ I la " f - TOWN 0 B.AkNNSTABLE LOCATION��` r' � 1, SEW VILLAGE ASSESSOR'S MAP & LOT"� IlvsfALLER'S tVAME & PHONE NO. >,3 SEPTIC TANK CAPACITY i f LEACHING FACILITY:(type) (size) y NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: `VARIANCE GRANTED: Yes No �'— �r 's. >i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH QW.t, ...........oF......... .1JS l ...................... Appilratinn for Rupnuul Workii Tonstrurtinn 'P.erntit Application is hereby made for a Permit to Construct ( or Repair an Individual Sewage Disposal System at: (1)� C�. r ............ _4:_M P1:E. :.............. i ls..._...� .. . 1............ ....--.............�...... Locat'on-Address or Lot No. ...................Ljr ......0 1 _ ................................ -----....---------------------............. ........ ................._...._........ Owner ---.-•-------------Address ...............Q ...k< ...._--- ------------------------------•------------•------------- ----..------------------- ess............_-....-............. Installer Address Type of Building Size Lot... .......Sq. feet a Dwelling—No. of Bedrooms.............`1'......................._...Expansion Attic ( ) Garbage Grinder ( ) ` Other—T e of Building ............... No. of persons..........................__ Showers — Cafeteria G4 Other fixtures .....................................1617. WDesign Flow............1.A.Q--•-••••• gallons per per pjr dey. Total da`ily,pow.................440 .......... PG Septic Tank—Liquid capacity .gallons Length..SD.L?... Width:.G-_�-... Diameter:............... Depth.....W._. W 1 ZS�...... Total leaching area.�t v_.sq. ft. x Disposal Trench—No. ................... Width._.. -........... Total Length... 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (,)4) Dosing tank ( ) Percolation Test Results Performed by.......`.�A. A)!Lssoj.)..............�................... Date•_�at `�.7..u......... `4a Test Pit No. 1...!:Z....minutes per inch Depth of Test Pit.._310..t.. Depth to ground 'water...l©.8...... �.. Test Pit No. 2..."—L.....minutes per Inch Depth of Test Pit.......1?JZ_.. Depth to ground water.....N OAJ.t... It- -rs-------------- . •---......................................................... O Description of Soil...C.2............. ra� ll ...24�-� .`�-� 51.►JD----.....1... .... .. -. .......----•----.........a....... x D.-24.....TP s ..24.E °.. ?sE.i�t.F�N GO.-(^±),L.+� ??..540 0.. Z M ..........-•-... �s ••-••-••---•---•-----------------•--......••••••••--•--••---..............•-••••-•••••-••---••••......---....... 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 LITL 5 of the State Sanitary Code—The undersigned further agrees not to plat he system in operation until a Certificate of Compliance has been iss ed b the rd of heal�l. Si ed......-- -•-••< i t Application Approved B a. ..'...... ..:........ Z:.. :. PP PP By............ -------•-•----.-- --..----- Date Application Disapproved"for the following reasons:............................................................................................................ ... ..............................................._..... ••..........................••--•.............••-••••-•••••--•--•.........-•--•-•••••-•••••-•-••-•........................ Permit No......-7r....5 ..... Issued--------------....------=---------........Dau...... Date r No.`s.. .4. THE COMMONWEALTH OF MASSACHUSETTS n BOARD OF HEALTH, ....... ..........OF....... � .1•? ?T1 h.1.. Appliration for 3liipn,ittl Works Tonotrnrtiun Permit Application is hereby made for a Permit to Construct ( X) or Repair an Individual Sewage Disposal System at: l,J^ . U- MAPI.�,`.�"c l�I A►�11J 1 S......... .........................4 61.......................................................... Locations Address or Lot No. .................. * ......M�1�Q�'` ................................ .............__.......---....----•--._.....- -•-••---•-------:..........._.....'-••-••..... Owner �/�J Address 5-------'----------------- M Installer Address ��U Type of Building /' Size Lot... .-�...:�'�._�_�_......Sq. feet Dwelling—No. of Bedrooms.............`'!'..........................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type e of Building No. of ersons____________________________ Showers W YP g ---------------------------- P ( ) — Cafeteria ( ) 04 Other fixtures .............. ......................I2�_.. W Design Flow________________1.f.....................gallons per person per day. Total daily flow.._._.__.________.4f ��-------------gallons. W ,Septic Tank—Liquid'capacity` lr?_gallons Length._. n... Width:. ___. Diameter________________ Depths=.....�0._. x Disposal Trench=No. ......t............ Width____Z..........._ Total Length.... -5_...... Total leaching area..?, !.�Lsq. ft. 3 Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (1,>0 Dosing tank ( ) 0" Percolation Test Results Performed by.......`5A_.�:����� ............ ................... Date.. ? I 7--__ Test Pit No. 1___�2-...minutes per inch Depth of Test Pit.....I Zc7A,-.-- Depth to ground water...X ?,)_........... 04 Test Pit No. 2.._"2-._._minutes per inch Depth of Test Pit........ Depth to ground water..... 04 ----------------------------•-:,•------....,;---___-•--•-------•------... ,' ---•---............................................. O Description of Soil...Ca--"-.�:�•-••rn('fiStl� �L�_..-1Qn ��r�= �SAOJA � � � ,-----------------•--_____----------•--- :. G'`-(nth" �s..•N��o :FiN__.'_-a......---.CoQ'-t?�z•_�? ?_:�:���t�-.. W ...•-•------------ -- ID 4 -_�., t P, VNature 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 TITIL- 5 of the State Sanitary Code— The undersigned further agrees to place the system in operation until a Certificate of Compliance_ has been issued by the board of health' 2 41 �` i' f�• Date Application Approved By............s�-I 1 _.-V-----------------------•-•---'-------•---•-•- .............. Date Application Disapproved for the following reasons:............................................................................................................ .............•-•----...--•-•--._...-----..._..__......_......_............-•-----•--------.._..._.._...-----------------•--..___.....-.-•--•----•--•--•------•--._...---------------...•-•.._.._...... PermitNo.••• .-•�---•-----•-••---••------•-•-•-_..... Issued...............•----•-------.......•''-----Dau...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH J oF. - .........)...tom:................. �,.�:::!r .c2d�................................. (Irrtif iratr aaf Gampliattre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by......... ' ................. ----------•-------____________...__---...._.........................•----------------_-___-----------_-___--- „^Q Installer at_____-•--- -- % ' 'iL---I-------- S�'1.-I------•--•�--------------------•----------•--...-------------------._._._._.._....._...._........_...............---.._.... 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.__.__.��..�__��_�_______. dated_...-_.__1J.1-f._i - '�..... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. r ` DATE..................... 1 � �i ...._.. Inspector. _' \ ........._... -_..... �. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH c �a O'�_"70' .............................. ..OF........ �•i al) NO......................... FEE........:t-............ Disposal Workii Tunstrurtiun Permit Permission is hereby granted__._ --�a�_ _,�____> ___ _,,,x��........................................................................................ to Construct ( ) or Repair ( ) an Individual._ �_ ndividual Sewage Disposal System at No l,f 1'Y1G1� --•--------•-••-•- ... -•-•-----........_..----"------------•-----------------••---.....---•--•--------•--------------•--•--•-......... Street as shown on the application for Disposal Works Construction Permit No..... Dated. 1lA-_�h �............. 7 ^ ...................— Board of Health DATE.................. ..----------�-� {�{ I j � � I � 1 � � i i e � t 1 1 1 v i - � � � � � � ' 1 i t i 1 y i i I �. � _ SECTION - SEWAGE Z. -SEPTIC TANK- -"O"BOX- ' -LEACH 2t 3c� �• � uD _..2..OF14TO 1h•• I WASHED STONE i 1 ,l j' �' ZZ I �I� 61 V I OY, IN• a { OUT IN• OPT• {SEPT C c. i /,'3v 18.0(s TANK •1,01 �(o.6Z�° a �, I 4 ELEV. ELEV. ELEV. ELEV. I v � Q _ ! ELEV. IELEV. 'JA WASHED STONE 5,2` i `' t•ice ' �O �I TEST HOLE LOG ' 1 C>✓ � �' '} TEST BY Gi li_,W(L,S074j NNIN6 ( �b.1�� TEST DATE 6"24 -$7 WITNESS DESIGN d' . .BEDROOM HOUSE T.H:.• 1 T.H. • 2 " _ac ELEV.13.9 ELEV .S. No Tov �1 t Z DISPOSER . a =.t 24,, dBso L -1(•9 24� vases i9 8 PERC"RATE MINAN.. DISPOSER �E 5E ED FLOW RATE I I a tcAL✓DAv�/ "' i'; # "� �G2� U IN1= - ^W SEPTIC TANK 4 0 (I.SIn flEO'DSEPTIC TANK SIZE A DJ.WATER $. I SAN LEACH FACILITY FETE w�r1=e + I O ` SIDE WALL-Z5'_6 2 )2 C 4 )=Z►F�5`1 Z ! . 5 4 a G/D. r -- — -- Jo!✓ 2� .9 . 80TTOM Z x 25 =. 505Fr l,0 !. G/D. t� - 2 -- �15.GS-AW05TMENT :DATb TOTAL v - o 39 TO 2(�� 5 TSlW- _ f -,. A�.tIi1 3_M E PST. -.O, USE: F)TJ E LE�tCHING M PLE �7 C.t ET WATER ENCOUNTERED NOTES: (UNLESS DTHERWISE NOTED) I }rl '•1J1.J 1.DATUM(MSLI:TAKE FIR M QUADRANGLE W4dn6 L F�-f�% A�,P ✓. +`.� � i 2.MUNICIPAL WATER 3.PIPE PITCH;M»PER FOOT 4.`DESION LOADING FOR ALL'PRE•CAST UNITS:AASHO- '� - S_MIN.OROUNb COVER OVER'AL.L'SEWASE FACILITIESs(1)FT. "•44 r ' a.PIPE JOINTS SHALL BE MApE WATERT101fT < z- r 7.CONSTRUCTION OETAtIi TO'�E ACCOROANCE-WITH;COMM.aFM/�S.S. _.. .; - - STATE ENVIRONMENTAL CODE AR" Q _,AR Gn; _' _ . SITE PLAN LOCUS ior� z� tJ as>=a r=o� 7ttcasi r'fG„f t_�uCT �ac.�vt� I V l �lo_�i17 _ _� .+�ss�sao 2K6 w v r `�C{E ocus• �4 �T�.eET Q or;F NGINEEqIEEE Rom - rzREF: ns IAAF�'�oG� - {9r�RLdown :cape vavinealo� PREPARED FOR: -tT'�o►,� CIVIL .ENGINEERS LAND SURVEYORS 'DOARD OF HEALTH R numn-SL 4( Lde. SCAL _ •---------'-' APPROVED OONTOURS {£XISTINd) MA (PROPOSED (o"PJ f3-1