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HomeMy WebLinkAbout0017 QUISSET ROAD - Health (2) S M EAD No.2-153LY UPC 12934 smead.com • Made In USA r SUSTAINABLE FORESTRY INITIATIVE Certified Rber sourcing wwwApmgram.org No.. 3...-.y... FE$.....�a............... THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH �u V� Applira#ion for Bispoii al ,ark aga r#iaaza rr �# Application is hereby made for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal System at• . .... . .........G 4 v r s Se --....... ap...---X�..... ........ Location- r �� ... --•-- X Ad ........................ � -I(.......r...... Installer Address 7/ Q Type of Building Size Lot.p���c3.P3...Sq. feet Dwelling—No. of Bedrooms.............. ...._...._...__.___.___.Expansion Attic ("'"r Garbage Grinder VT '4 Other—T e of Building ............................ No. of persons............................ Showers — Cafeteria Pa Other fixt s ........----•----••--•-------•- d' Design Flow........... ... ..........................gallons per person per day. Total daily flow_______7,�.�1-----_____---____-__--_-___gallons. W WSeptic Tank—Liquid capacity/PeP_gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.....r..� ------- Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No---------/--------- Diameter....f.P-h____- Depth below inlet.................... Total leaching arglt9.55.L.A. ft. Z Other Distribution box ( ) Dosing,tan} ( ) c '—' Percolation Test Results Performed by _. . ..�. ��� Date....... .... ................. aTest Pit No. 1__4Z....minutes per inch Depth of Test Pit----------•--------- Depth to ground ater---- P% Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ - ------------ O Description of Soil L-✓ . t ----v �1.� •-----. ��___/..z-. l�1 s19 N� x 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'TTL y g g p y 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. Sied...................................................................................... --------- ate Application Approved By..';;.... ----•-•-•.................•------••--------•--•---------------••-•-•••-- ---- ��40................ Date Application Disapproved for he following"reasons------------------------------------------------------------------------------------•......--•-••......---------- -------------------------•••---------•---•--•-----------•-•--••---------------•---------•-•-------._...•-••-------------••----•----•-----•-•-------------------•----•----.............................. Date PermitNo......................................................... Issued_....................................................... Date _ s Fims....9.. ................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF _HEALTH t�. Ve Applira#ion for U44#oii al Workii Tnntrurtion Frrutit Application is hereby made for a Permit to Construct ;��) Ol Repair ( ) an Individual Sewage Disposal System at ........ .. �' % t-'..�---......�. �}. ......._ r� _ <_'�.f, :.. �............ ... .--- p_Loaio • ss or IN � ......��....... .......................................... . ....... ..... Owner V Addr ss Wa /rr�- ' ....< .....-----•----•-•---..... _.1 '/..t........1 -1 s 1Tf �> :... Installer Address Tvpe of Building Size Lot :)f..?U_=%._._Sq. feet Dwelling—No. of Bedrooms..................................___.___Expansion Attic ('� Garbage Grinder (N� aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a Other_fix res •----•-•---•----•------------- Desi n Flow __:............................gallons per person per day. Total daily flow....... 1D , W g g P P P Y Y ---------------------------gallons. Septic Tank—Liquid capacit/,6P..gallons Length................ Width---------------- Diameter................ Depth................ W Disposal Trench—No..................... Width................... Total Length.................... Total leaching area.....................Sq. ft. Seepage Pit No-------- Diameter.40A______ Depth below inlet.................... Total leaching ar2a/_25_s_/f3q. ft. Z Other Distribution box ( ) Dosing tan ( ) '-' Percolation Test Results Performed by.__ J .. .f4:c:.(.Lj'- Date___ Test Pit No. 1..-== ...---minutes per inch Depth of Test Pit.................... Depth to ground water... I, . Test Pit No. 2-_-------:--__minutes per inch Depth of Test Pit.................... Depth to ground water......._.._._..._..._._. a ................. ,. . --•---• - f --•- - --------------- -----•--- ---------.--._.----- O Description of Soil--=----••---�..............�._.....✓--..................................�-------��-�--"------T�---•1• ------------•-�-=--,'--..-...�.��iJ��` x V ...-••--•-••-----------•------•----------------•---------•-•-----•-•----------•-------------------•----------------•----•......-•---•----•----...........................................•-------•---- W -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 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 i?. � y g g p y 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. S- ned-•----•----•----•----------------------•-•----•-----------•--••------•-----...-•--••. --•--------- >. Date Application Approved By ��'' �..lA Date Application Disapprove for the following reasons-----------------------------------------------------•---------------------------•---------. Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H AL H V-. �-t..�...........................OF....... . ..:................................................ Trrtif iratr of Toutpli anrr Si.- TO CERTIFY, That the Individual Sewage Disposal System constructed r ) or Repaired ( ) by..... •---=-_:fir......... • ................................. ..... . ... .. ^I--•- ------------------------------------------------•--------------•-------------------•-------- at............... -•-: ....... ... eau----- --------- -------•- ------------------------ has been installed in accordance with the provisions of T `'LE j of he State Sanitary o e as escribed in the application for Disposal Works Construction Permit No.- 3_"--`y�=y--•----------- da.ted_­'/_' lo' ________________•__----- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST ® AS A GUARANTEE THAT THE SYSTEM W1 dL F/Y�NCTION SATISFACTORY. DATE.../1....3° ..k........................................................... Inspector---- --- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........................................ ..OF.....................................................................................NOY.�-- ---------•-- FEE:I' .. ................ Miwjjs , kg 0.111nitrtulion rrantt Permissioni Hereby granted- ------ ---------- ......................................................................................................... to Construct or aitxarl. ' nal .vra • - ge-Disposal System at No. - .- ----•.................... ------- -- ---- ---------------- ----- -------------------------------------------------------......... .......... 1 Street _ as shown on the a pli ion for Dispo Works Construction Permit Nc-__- 4_� ; d:�__��.. ;**...... ........................................ ----- ....................................................... B and of Health DATE- ............................................. FORM 1255 HOBBS & WARREN, INC., PUBLISHERS Sl TE PL AN T YPII✓AL PROFIL E SCALE 1 = NOT TO SCALE -� 18"STD L T WGT C.1. MH COVER }4"C I. PIPE 4"B/T FIBER PIPE TIGHT JOINTS ----a FLOW LINE _ OUTLET LEVEL TO FIRST JOINT — -- -- -- --* DWELLING �a•.�9. o;, _— /4 ] Ott 0O • �i C.!. TEE i � m L � i '. j I 7 C.I. TEE _- 1 - --1 STANDARD PRECAST ' 14"�- CONCRETE !oteGALLON SEPTIC TANK OISTRIBUTION 13OX ,. TO BE /NSTAL L ED ON LEVEL , Sr,.'BLE BASE SEPTIC TANK TO BE INSTALLED ON LEVEL , STABLE BASE 9Tn. r�n>�ca`T GovG. ,yz ; L58.o 2"- 118 TO 112" WASHED` PEA STONF L EA CHING PI T ALL AROUND FREE OF IRONS FINES BASF TO BE L E_ VFL � AND DUST /N__PLACE BRICK 8 MURTAR COURES h T f?, f' C.ahT ll A 314"" TO 1-112"" WASHED CRUSHER 4E,Lvc. Iueo CaA4 . I� AS REOUIRED TO BRING STONE ALL ROLIN& FREE Of u ,- r��,r�t�•� s__��acl4 �h r i.c T �+ �• ,q r7 1, t �,% e r' COVER ,T 0 GRADE 2AND 1 FRAME COVER IRONS, FINES AND DUST IN PL ACE v 14LO-1 J-3� 4 -FLOW LINE-- _` L EACHING Pl T SEC TON- �' - --- - - --- - I PIPE I. CONCRETE TO BE 4000 PSI 28 DAYS •:\ II I 2. REINFORCED WITH 6' K 6" N0. 6 GA. W.W M f m1�� 3, 2' AND 4' SECTIONS ARE AVAILABLE FOR GREATER DEPTH REQUIREMENTS OPENING WITH 4-1 8"" i 4. NUMBER OF PITS REQUIRED c U OUTER DIAMETER Q 1-314INSIDE DIAMETER ! 3„ NOTE: EXCAVATE TO ELEVATION �w e'_OR LOWER AS trti _. REQUIRED TO REMOVE ALL LOAM AND CLAY BENEATH f PIT. REPLACE EXCAVATED MATERIAL. WITH CLEAN GRAVEL TO DESIGNED GRADE t 7 I 1 /tl M/N. EfFECTIVE DIAMETE-47 (NOT TO EXCEED 3 T 1 MES EFFEC T/VE DEPTH) WATER TABL E SOIL AND i-f-SC. OATA ---- GENERAL NOTES PERC. RATE : = MIN. /IN . NO HEAVY EQUIPMENT TO RUN OVER SYSTEM F SEPTIC TANK, DISTRIBUTION BOX , LEACHING PITS TC BE STANDARD h' w , r�rc TEST BY: G � l-i � C> ( lti:'M, lti/,� �ulIG1� s As�ioc. ;�dc 5 , .� �;A :v. rh nnT PRECAST REINFORCED CONCRETE UNITS 0� WITNESSED BY: S2o "t 64 ° F � V i �' �+ i ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE , �✓ TEST PIT GR EL.' ��. . �' DATE ' 4/ zv���� ----- MINIMUM REQUIREMENTS FOR THE SUBSUFACE DISPOSAL_ `?F TEST PIT NO. I t�lo� r,�, TEST PIT N0 2 SANITARY SEWAGE EFFECTIVE I JULY 1977. L) ( h Gj `7'" (-4 © A O' — 0"__ ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE Z g' T,'l P 5 ?_2 h I L. A ( -- ' BOARD OF HEALTH, AT COMPLETION OF CONSTRUCTION , PRIOR TO BACKFILLING, THE e- A �_J C> BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. PITCH ALL SEWER LINES I/4" / FT. UNLESS INDICATED OTHERWISE. ►.Jv u/ AT DESIGN DATA _ BEDROOMS _ DISPOSAL EST. TOTAL DAILY EFF. L EGEND SEPTIC TANK I GAL SIDEWALL AREA GAL./SQ. FT. BOTTOM AREA I o GAL./SQ. FT. SEWAGE DISPOSAL SYSTEM gm, O -'rO EXISTING GRADE LEACHING REQUIRED 1 �3 ' r�2SQ FT rJ if ~- �`a od FINISHED GRADE SOFT. FCC!? ZONF_ ___ .' ACTUAL. LEACHING AREA ?c'�� �3 DOMESTIC WATER `jQURCE ' L. U -; •i� °� _T `� -a- oo I INVER? ELEVATION' .V YIL� 7..G r Y wrs' L D (-J - —-- PROPERTY L.I N E M �'f.44�;p G rJ T r~�2 �� t_ �c r ,a rz h TA- rf r ►.A b.5 t. P L_A N P,F F E R E N C E _-- _ �_.---_----- MEAN HIGH WATER ; I! • 4` SCALE A INDICATED DATE -' 1 & � /' E BENCH MARK DATUM' c r-A u C-4 y -(• v = r= - MARSH .>. WM M Wi4RWlCK 8 ASSOCIATES Ov Zvaf �1vti� ra /> z BOX 801 - NORTH FALMOUTH '�° � �: MASSACHU.SE T T r 02556