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Home My WebLink About0082 FRAZIER WAY - Health (3) 32 Frazier Way Cotuit i A=057-006-007 r I 664 No.......... Y- Fim ThE COMIMONW-E-A4—Tij OF MASSACHUSETTS BOARD OF HEALTH,,-_ , 7...................OF..7BA". .5TA-.BA". ............*------------------Appfiration for Bhivoiial Workii Tongrurtion ramit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: .......................................... .................................................................................................. Location-Address or Lot No. .. ..... .04�� .................... .................................................................................................. wner 24P.r:!� T Address Installer Address Type of Buildi Size Lot............................Sq. feet U �-4 Dwelling No. of Bedrooms.................a......................Expansion Attic Garbage Grinder ( ) �4 Other—Type of Building ............................. No. of ersons...........(�............. Showers Cafeteria ( ) PL4 p P4Other fixtures ..................................................................................................................................................... Design Flow____._.____ JW.___________________gallons per person per day. Total daily flow........:��3Q.......................gallons. 9 Septic Tank—Liquid capacity.IAOO.-gallons Length................ Width__.__.______.___ Diameter.____._.._.__._..Depth................ Disposal Trench—No_.................... Width.................... Total Length............ Total leaching area....................sq. ft. Seepage Pit No........I........... Diameter....... ..... Depth below inlet_______._._.___. Total, leaching area.AQ-6...444.40AI-e. Z Other Distribution box (>O Dosing tank ( ) 11 Percolation Test Results Performed by--- 4 14*...45�50.*R-71 6...... Date....I.Q=5 ...... Test Pit No. .....minutes per inch Depth of Test Pit-----1.4........ Depth to ground water_._ e-, Test Pit No. 2................minutes per inch Depth of Test Pit____________________ Depth to ground water_:______________________ ..................................................... ............................................................................. O Z,4 -- -- ---- ---- Descriptionof Soil___.___` --&�...... ......5q. -----------t,.................................................................. U ..................................... ........M.ep...... ....... 4AAe19-e................................................................. W ----------------- ............................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ........I............................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 1117 7 5 of the State San• ode—The undersigned further agrees not to place the system in r- 771S' ssu operation until a Certificate of Compliance h b!etenssu Wbyh oard of health. Signed........... .. ......... ... . ............................................. ................................ ApplicationApproved By........ . .... .................................... ...................Date-- .............. Date Application Disapproved for the following reasons:.............................................................................................................. .................................................... ................................................................................................................................................... Date PermitNo........ ... ............................ Issued....................................................... Date I,Ifilflffl��IMII No................-....... Fi$..........................._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH. s Appliration for UWpooul Works Towitrurtion truth Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: n L .._....... ..................•---...........-•----------------------------....... •-----•-•---...----••---•........--•------•-•-----•------•----------------•-------••--------...._. Location-Address or Lot No. ...Kf-------�L✓....._ .f../�..�s�.--•......................... ........................................•- --.......-------•----........................... Owner Address W .................. .•----................_...•-•----••-•-----................•-•-----•-••............------.......... Installer Address QType of Building Size Lot............................Sq. feet Dwelling X No. of Bedrooms................`�____._.____._.____.___.Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria 04 Other t s •------------------------------- Design Flow........... .... _...._..............gallons per person per day. Total daily flow.___._..3.....�...._.............•....gallons. W 10007 WSeptic Tank—Liquid capacity!_.......__.gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width......I.............. Total Length...........T....... Total leaching area....................sq. ft. Seepage Pit No.......I............ Diameter........_...... Depth below inlet.... Total leaching area4L6...gA"#-e- z Other Distribution box (A) Dosing tank ( ) `-' Percolation Test Results Performed by._.7-/D 5 G-.N l� 5 P Date.... - ---------- - aa Test Pit No. 1.�.Z"_____minutes per inch Depth of Test Pit �_______________ Depth to ground water.._._.o�c �G (z, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gd ----•-• ------ ------ .... _------- Descriptionof Soil. -• �J .... •------•------------- �------------------------------------------------------------------------------------ V ------------------------------- •--•-----•---••----------.---- ------------ --- ----------•-------•--------------•-------------------------------- W ---------------------------------------------------------------------------------------•---------------------------------------------------------------------------•--------------------•--------------- VNature of Repairs or Alterations—Answer when applicable_____------••------------------------•-__._•_-------_-_------__--_____-_-___.-_-_-_..__-__._.-. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with f'1T�'1�^ ' the provisions of :T 17 5 of the State Sanr at ry'( ode—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been/Issud by h oard of health. � - Signed---------.................. ------ - Date Application Approved BY - j------------------------------------ Date Application Disapproved for the following reasons:..............................................................--------------------............................_ ----------•---•--------------•---•--------------....----.._...--••--••----•-----.._..........---------•---•----------------------•--------------------------------•------------------------------------- [�. Date PermitNo....... ............................................... Issued....................................................... Date 4 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......................OF. n.2USTi�sc...c a�.._...:............ . .............................................................. fill vortifirate of Tompliunrr THIS IS O �ERTI�FY,,3 Xat�the¢,Individual Sewage Disposal System constructed (�O or Repaired by-----------------------------e v ---------`*----------------- -------------------------------------------------------------------- ------------------------------- Installer 7 . Ai- Alfat------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ has been installed in accordance with the provisions of TITIZ ` of The State Sanitary Cod as described in the application for Disposal Works Construction Permit No f q`_._ Pt r - a f -----------------••... dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRII AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATh= ............................................................... Inspector •---------- ----- HO'F� [vASSACHUSETTS �r �E COMMONWEA�Tr � BOARD OF HEALTH � v uJAJ �2A/S?W/jtr No........ a ' FEE........................ ion�a 1 rk0 Tonstrurtion`Urrutii Permissiouis hereby granted............................-.......................' ---------...-----------..._..._..---.................................................. to Construct ) or R�pair ) an Individual Sewage Disposal S stem atNo...................................................../, r ...............................................a� G Tt-----r-- '----(--------------------------••---............ Street as shown on the application for Disposal `'forks Construction Permit No ................. Dated................................ ........ Board Heal- of ......•. ......... D ,, � t . , FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS - S 0 1 L L0G NO.1v1 F NO. 2Top SITE PLA- N —►''✓ _� CLA-( a --/0/ 2 3 _: - 4 - - - TOP OF FOUNDATION El .: i� � �y~T - 5 0 —_ :.• _ E� ,o3.71 lMa>L �'Gvy MAD sr,Na � �.�:�_ys 8 E� N :7QA✓G v p. ---- __ O✓� -r.— }ef4 —t ° IN EL !02 1D �- --• J f.•. .. Vint - r . 1i -- i. .� , .J•� _�; 1' COVER 1/8 3/8 WASHED STONE z 12 �- --- i ., IN El l� f L'1IN El �.1 — r— =- r ' i L IN EL l00 ., 13 i•� D/ B WI 6 SUMP --' �', �� : - 3/4 1 1/2 WASHED STONE ~--�---� 4 LIQUID LEVEL �.� - `. --+ I. ° Ir � � - 14 6' EFF. DEPTH ` ,� - 15 ' PERC TEST RESULTS PRECAST SEPTIC TANK WITH , PRECAST ' LEACHING PITS PERC RATE : � A n � ., c I F CAST IN PLACE INLET AND - WHITNESSED BY: __. p_�a__ � OUTLET T "S PER TITLE y EL. - _. �_4 °� �� t _ _ �L___� NO.: � SIZE : � '/�- �._Y_sz�=F_F __��_ BOARD OF' . HEALTH SIZE : t'- : 01A . - DATE : _. e_ DIA . p --7�8 , Y IloS f 1v 4 103 Z eo� I PROFILE OF PROPOSED SEWAGE SYSTEM SYSTEM DESIGNED BY THE TOWN OF _�A >3aL� ____ REGULATIONS AND STATE TITLE y- FOR SUBSURFACE DISPOSAL OF SEWAGE . SCALE : 1/4"-= ID " N . B . 1 . All PIPES SHALL BE SCHEDULE 40 P.V.C. SEWER PIPE 2. All PIPES SHALL BE, SLOPED 1/4 "' PER FOOT EXCEPT FOR �' ' �y -rP w THE FIRST 2 FEET OUT OF THE D / B WHICH SHALL BE LEVEL / - 3. DESIGN FLOW ___�? BEDROOMS AT 110 GALDAY PER BR . GAL/ DAY� ygx9 SEPTIC TANK SIZE X ls_=_ 4; GAL . USE GAL. W/ GARBAGE DISPOSAL lot / LEACHING Y TE �— ti a�- r ► FT , Lr-- hC+� 0 � 3�,. �,�. � 7, S S M USE I / � I � � EFFECTIVE AREA : SIDE w , Ali t f BOTTOM _r _ xBL ¢ y �� _ � - -- MY i Tow TOTAL FLOW 4 zi_A a-f i ,� T< L TOTAL REQ O FLOW 33a_ X 1 , 0 W/ )r GARBAGE DISPOSAL - , - - ,a� RESERVE FLOW- _4_z� -33� _-_q GAL/ DAY I v 0710 i }� �_►. �'' =) s irk f 7:l04 i REFERENCE PLANS _--- - -_- APPROVED BY : - ----- 13A1?�.,s-rAbLE BOARD OF HEALTH sr- A4 1Ei 30 -- -- - - -- - -- -- SITE AND SEWAGE PLAN PROPERTY OWNER : __ �:_ti ��.�.__. �. �..._n �_T�� i�� _ FG 3 IRM2oonn 1;1 N GLL• FAM It"( C�wSLA ► w C. - N r _ . 1 , � •. : . DA TE- - z - - �iifn t. ,r� w I LL 1 A M 1 t d E 12 C1 t1t�l - P E