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Home My WebLink About0033 GREAT HILL DRIVE - Health C-�/e - p✓jve, Ca4,ku,�1� i�13 � 0W .u� .................. THE COMMONWEALTH OF MASSACHUSETTS , BOAR® OF HEALTH ............_jl� ........OF.....................0,0. P�. 1.�1L ApplirFa#ion for Disposal Works Toustrurtinn Frrutit y Application is hereby ma e a Permit to Construct ( �( or Re pairy ) an Indi 'dual Sewage Disposal S a ` AL if' .......A--------------------------W_Wn ..................... ation-Add s e Lot No e ® or ----------------------------------.... ..._........ l� �.. •--••••--------------•--•--•-••••-•..........------ Owner �°� J Address ��.........f -�� ------•--.••••-- --•---••-----------••------- ......................... Installer � Address Type of Building Size Lot-Y .f.S.4e....Sq. feet Dwelling—No. of Bedrooms...................... ..........--.--..Expansion Attic QVD Garbage Grinder Other—Type of Building No. of persons............................ Showers a YP g ---------------------------- P ( )--- Cafeteria ( ) d Other fixtures . W Design Flow................ 5�.-..........._..gallons per person per day. Total daily flow...............1.3...Q............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 ( ) `Percolation Test Results Performed b ----_-------------------- � � � �l e a Y ---------------- •-_. Date. -�•----------- Test Pit No. 1.....��inutes per inch Depth of Test Pit...... Depth to ground water------.�!..� - r34 Test Pit'No. 2........ _...._minutes per inch Depth of Test Pit.................... Depth to ground water.......--............... P4. -----•----••-•-•-••--------•----•---------------------•--------..... / - Description of Soil-•----------•-----•------------------------------•------••-----------•.0.. C iq"� S�C�.3pf_ �- x ---------------------=.1-�-41------.-------- t.Y�l�:.�•...T�_..f ��..._�: ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•--•. 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 LIT L 5 of the State Sanitary Code— The undersigned further agrees not t place the system in operation until a Certificate of Compliance has been issued by the board of heal / Application Approved BY : .... . .. ............•....--•-----------------•----•--------...........---- ��-- Date Application Disapproved f th following reasons:..........-................................................................................................... _ ............. .................••------•------------------...-----------•......---------------------------------............................................................ Date PermitNo......................................................... Issued....................................................... Date c:} t .................. THE COMMONWEALTHOF MASSACHUSETTS BOARD OF HEALTH .... ......... ....... ..... Appliratiou for Disposal Works i>lonstrnrtinn ramit r Application is hereby made for a Permit to Construct ( ')� or Repair ( ) an Individual Sewage Disposal System at: . �2 � `+. I- • Location Address + f ' or Lot No. ' LIn 3 o Owner f Address n ll I sta er Address UType of Building Size Lot_.((5.,1 •4sk ...Sq. feet Dwelling—No. of Bedrooms_____________________r... Attic f� ,Garbage.Grinder a`4 Other—T e of Building ______________ Other—Type g ______________ No. of persons___.______._____.........._ Showers ( ) — Cafeteria ( ..) Otherfixtures----- -••-•=-•-•----------------- -----••••-•---•-------•-----•-------•---•••••--••--•-------•=-=-•------------...._-•---..__....•----- W Design Flow............. 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 ( ) ` ~' Percolation Test Results -Performed by-----••--------=---=------- F ...............•-••--•••• Date...... ¢....................---�!a Test-Pit No; 1_.:: .�:minutes per inch Depth -of Test P'it___:_It_'1_' - _`Depth to ground water•. / 7 (S, Test Pit No. 2.___::. ____minutes per inch Depth of Test Pit..................... Depth to ground water..:___..__�____r___. O ...- ................................�� p ------•--•- ---- - Description of Soil .......................--._ _........._ ""' S, -� C t44-1 4 --------•------------------------------ 5t „` ! 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 undersigned further agrees not,tp place the system in operation until a Certificate of Compliance has been issued by the board of heal y (� ed......sr:.......•..l `�+a',i `•- ° :_.. .(. ,.-"'f- --------- •---A ��/�/�-�� Application Approved B - _"� - - /� - :._.. Application Disapproved f o, tate h 'following reasons:__._______.`__________________________________________________ .....................•--••---Date........._..._ --.......-•--•-•----...---•--•---•---------------------------•-•-•--.....------------•---•...--------•------------------•--------•--- -------------------------•--------------------------•--------•--- Date rPermit No......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..... AOF. ... _. �# .... .. ....... ............... Tn#ifirat e of Tomph atirr THIS IS TO"CERTIFY, That the Individual Sewage Disposal System constructed (k) or Repaired ( ) by.................................... >�';- ............ I't d S-G -I/:----------...----•--.............--- --- -•------ .......... Installer Z!'� has been installed in accordance with the provisions of TITLE` 5of The State Sanitary Code as described in,the applicationtfor Disposal Works Construction Permit No._9;11y."__ 1.7_________________ dated.........................................._..... 1, THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM W. F CTION SATISFACTORY. DATE.... 16 . �� Inspector ________ ____•-•--•----__:_..........--•--•-•--•-••---- ••••------•--•••---•---------•-••----•--••-•-•-•-••---•-•-•-••....._. c THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No.�--•------ %' FEE .................... i Disposal Workii %Dnnstrnrtion Trani# _ Permission is herebyranted....................________________� __. ,.... � v to Construct„( ) or Repair ( ) an Ind ual Sewage Disposal' System -- at No. --- -' Q Jt St�eet` as shown on the appli tion for Disposal Works Construction Permit No—.,-,-" _ ____________ Dated.......:.................................. fy - -----------.......................................................... �/` Q Board of Health DATE --- w FORM 1255 A. M. SULKIN, INC., BOSTON F 71, 6 y, r - N �►U p�?4l� -,4 ,. 1 6 = w . -TAG ✓2 �F—FiF T T� QJ 0 0 E � C15 le 5,0 Fr � OF ► 4is �a��, CERTIFIED PLOT PLAN AL 3• RG[ick( , ti ryl 0 SE LLURM vt No.10951 Q ; y 1 N ONAL. SCALE DATE S %.ci.✓&.._�,�. 1:�rLDREDGE ENGINEERING CO IN CLIENT I CERTIFY THAT THE PROPOSED EGISTERE REGISTERED J08. Id0. r93 �'� BUILDING SHOWN ON THIS PLAN CIVIL LAND CONFORMS TO THE ZONING LAWS ENGINEER R Y DR.BY' . �4 OF ARNSTABL + MAS 71.2 MAIN STREET CH. BY+ N YA N N I St MASS. $HEET� 0>: 0 ATE' REG. LAND SURVEYOR q 20 FT Mt/V. N.074 `1R EITNER TN.E SfPTlC Ti�NK OR LEACNZMS -p/.T A @Er NOR& THAN /a"BfLGM% �ZEJ. 10.Pl../W/AI. RAOJFj o41 ""p/AMFTER CONCR07-AF. .COY&X?' SHALL.E�•9!�0tl6NT TO 6RAjpz �f .�AN FiKTi?A ?5 b CONCJ:CTs AWN. P/TCN JYEAYy CAST//SON C O i/C`R Ss/.4 L L BE USFO a COVERS s' /FJN DR/VEy{/A y 2yro MiN. CGNCRE TGo dk•4o CO NER -CLEAN SAND, U�U/D LEVEL . : • _ - • - � � / ONP I .? LAYt R %F 1 M/JV.P/TC/t �'�v Cs14L. • •eo 11 • •. .• • • • •,• " QF v P!f/q J°7: D/ST, o • WASHED STONE SEPTIC TAAIN evX • + • • • • • • • • • s . • _ - — lo • r •• pE/,7Jr,� • • • . • •y . WASHED STONE ;� VEYuFi�v D[J2rNG �iGCAV4 170� l7s9 XZ,S=. l fU SZL7, e • •� • • • . e • e • • • • �rNA �• Z,lo i s, r • e e o • • • • ► :• PRE�,AST SEEPAGE 1N EL�Y.�T/AiNs 15-3.9 r - ISM e i�• • • • • e • • • • e '► P17 OR L�QU/V. 55'y G�/DAY • s �' 60�. o /NYERT A7' ®l!!LD/WG 3. . O/AM.z 14 /NrCE7 .SEPT/C' TRNK. 7Z8 FT, L_ �` _FT. O/i4M. CCEvL'4TJO/V� DUTLET SlePT/C TA vH LFT. INLET sox 7Z,V F7. GROVAID PVA"rER TilA E O&7ZZrrD/57 q/®!!T/ON BoX 7Z.2 SECT/ON DF /,V .FT LEACN/MG P/T 70,0 Fr .SEWA SE VASAASA L SV..STEM L EACts///VG =/T TABIJLATIDN SCALE �4" _ /-O- D/MENS/ON A Z FT. DESIGSN C°,�/TL�/�/A D/Jy,ENSION �---i�FT. NUMSER OF EEDROOMS O/HENS/O/1! G 6- FT. : G^RCAGED/SPOSAL UN/T No�� SO/L �®G TOTAL EST/A►�TED FLO*V 33[� G.4L.1,0Ay SOIL. TEST 01 SO/L 71CS.7-#2 SO/L TEST il/UMBER 04r LeACKlNG PjTS �^EtEY. -7I.7 -�LPy OATS OF SOIL TEST/ S/OE LEACHING PER P/T �S!� PT. 3 /�� Gr l f F'G rc'� /� U - RESULTS h//TNESSED BY ,, BOTTOM LE�ICN/NG PER P/T Zf3y W. FT. G ` �. rvl f1ERCOlAT/ON RATE 7'OrA4 LEACHIWer- AREA SQ. FT. St.,i; S o PENCOI-A7/oN RATEA2 7-1 ljV./INCH RESERt�ELE.�C'N/N6 ARE/► ° SQ. FT. '_ Z•U / r 1 ��'•� OF 4ps9 hJer }+ v f Cr.,�. - AL LOT 3 GRCfi 7 I/Ic.L �r< ✓ z- ORSE Cl=/V7��T�' //L..L_ t!5 Ui26x�Y o No.10951 p -4 VIL- y tF p G ;+ �' . ��.•", - - SsiONAL E� - EL DREDGE E/YG/NEEI?//VG CQ,/NG. U/A7E�F CL_ 6O_o 7/2 /y.41N .ST., HYANN/9, MASS. ❑ NOGROUNO YYATts/rP ENCOUNTERED CL/.ENT:Ge�c-Nr3,elE�p,�TE: , ,3 a _�,>�`� � GRO UNO lw<1 TER AT ELE'✓. D? JOB vo. =- t� V f r f errni t Nui her: Date: e; Completed by �5 HIGH GROUND-WATER LEVEL COMPUTATION .c, Site Locc�a•^ti on:- C)g- Lot No. 3 Owner: Address: Contractor: Address: Notes: STEP 1 Measure depth to water table 7 to nearest 1/10 .ft. . . . . . . . . . . . . . . . . . . . . . . . . . �_/=s/�S�I- _J date STEP 2 Using Water-Level Range. Zone and Index Well Map locate' site and determine: �SD� A) Appropriate index well . . . . . . . . . . . . B) Water-level range zone . . . . . . . . . . . . I T� STEP 3 Using monthly report"Current Water Resources Conditions" - -- -- determine current depth to water level for index well . . . . . . --- rno y r STEP 4 Using Table of Water-level Adjustments for index well T5_F EP 2A current depth to . water .level for index well (STEP 3) , and water-level -- zone (STEP 2B) determine water-level adjustment . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . STEP 5 Estiriate depth to high water by subtracting the water- level adjustment (STEP 4) ----- from measured depth to water level at. s i to (STEP 1 ) z ` LOCATION SEWAGE PERMIT Ne. ' L-0-� '4 3 VILLAGE 1�l�•-- � �' �6v�—tee�Y � �� 0 6� 9 I N S T A LLER'S NAME i ADDRESS T. i)�;Scal) w►0,c r iM; 1� BUILDER OR OWNER DATE PERMIT ISSUED ® DATE COMPLIANCE ISSUEDia 1-