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HomeMy WebLinkAbout0106 MARINER CIRCLE - Health !o Ip rc le co oz3- o� 2 LOCATION COCA-RLtjeg SEWAGE PERMIT N0• 6 - � � ® _ 7 _ V I L L A G(�C) INSTA LLER'S 7 NAME i ADDRESS s U 1 E R 01t OWN ER 5112 e L 0 h DA T E PERMIT ISSUED DATE COMPLIANCE ISSUED��_r , 75" a I � X �6 �- ......�.�.... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ��.. ................OF......e /v6C . ...... ApplirFation for Disposal Works Tonstrur#ion Prrutit Application is hereby made for a Permit to Construct 0' or Repair ( ) an Individual Sewage Disposal System at: r..._•••-•-•------------ to. L c ' Addre ramY� or 4r ; f = °T- ............................................................. ne Address l Installer Address Type of Building Size Lot...1. .�,4...�..... ...Sq. feet Dwelling—No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building DX! J�Vc -... No. of persons............................ Showers ( ) — Cafeteria ( ) P4 Other fixtures ............................ . ----------- W Desi Flow........ _ ........................ allons er erson er da Total dail flow......'3 ........................ lons. �� �-- -•.. g P P Po is y A daily � WSeptic Tank—Liquid capacity.lCO.gallons Length�._'�_..___ Width..�.�...... Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length..........o...... Total leaching area....................sq. ft. f Seepage Pit No...______._�__..__.. Diameter_._....$ ..._..._ Depth below inlet._. _._._.. Total leaching area..................sq. ft. Z Other Distribution box Dosing tank ( ) j 0-' Percolation Test Results Performed by.__._..� ��` �'?r�_ � f •- •.............•----- Date...,. ,1VZY...........•-•-. as Test Pit No. 1................minutes per inch Depth of Test Pit....._.............. Depth to ground water..... P ti (x, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ RS •-•---------- ---- O Description of Sow �._.......� _�....: � � v __4s..._Description of...... •.................................................................................................................................... x •-•••-•-•••-... -- -•---•--•-•--------••-------•-•---••••-----•-•--••-•-••-----•-•----•-•---•----•-•-•.............••- 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 TIT .;,,. 5 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 t e board of health. Sid... . j! .--......-•................... ...... Date Application Approved By..................... --•-•--- . ••.... ...-•-•......................................... ----•-Z D ---••-...---_.. Date Application Disapproved for the following reasons:-------•--------------••---.....----•-....--•---------...--•---------------...----------•---•-•-•-------••--•... -••----...-•-••-•----•-•-•---•-•----••••-••-••••----•--•-•....--•--•---•-•••--••..............•••-•----•----••-•-•--••-•-•-----••-•-----•-••--•-•---•••••••----•--•-------••-••----••-••-•--•-••-•-•--- �--. --•---Date PermitNo......................................................... Issued.-.----.111__.... ................... Date -t 0?. 7 - es"'f Now�.....1_._:._.... FE$.......3 ..."' THE COMMONWEALTH OF MASSACHUSETTS f� BOARD OF HEALTH .................OF.... ,c....... le f ' Appliration for Dispoiial Works Tontitrn.rtion ramit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: . �Q_............ ....��la............................ ......................................... L. "t' '• s '.. ..... T 7 7 Addres�•- I or o. .....__... ..... .............. �.[ Ldf�N Owne � Address a �f'( 'r............ .......................................................... .............................................................................................•.... Installer Address Type of Building Size Lot...,9 0-C© ...Sq. feet .., Dwelling—No. of Bedrooms........................ ....__._._Expansion Attic ( ) Garbage Grinder ( ) No. of ersons........... Showers — a Other—Type of Building 1.�- ..... p �'................. ( ) Cafeteria ( ) dOther fixtures .......................-4........................................................................................................................... W Design Flow.........,7.. ............................gallons per person per day. Total daily flow_....�'��. ........................gallons. WSeptic Tank—Liquid capacity.!-Cr gallons Length-�-iy".... Width.�!lC.. Diameter................ Depth................ x Disposal Trench—No..................... Width........................ Total Len gth...._..._ ___��. Total leaching area....................sq. ft. Seepage Pit No...........�I-------- Diameter.......`_._...... Depth below inlet..7..3....... Total leaching area..................sq. ft. Z Other Distribution box Dosing tank `" Percolation Test Results Performed by.......t`�1�!�? _........0.1............................... Date... �...•---•----•_-. a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.....flv.� GXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ V ..:.. r-ODescription of ------------------------•-•--------------------...----•-.----••--------..._....•---....--------- .._...... .......................(t� w ......•-•---------- ca--.!0`....-- - ''t ----•-••-•---------------•-------•---•-••------------•---•-----•--...-•--•---•--------.........-•----....---•••------. x Nature of Re airs or Alterations—Answer when applicable.............................................. ---- -----------•----------------------............................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions.of'TTLE, 5 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 t e boar health. Signed.. --- --- -----------• -------------------------••--------....-- '�3 __/ _.._._. Date ApplicationApproved By.................................................................................................. ........................................ Date Application Disapproved for the following reasons------------------••--------•-----•----------------------------•----------------.........-••-•---..._... ....................•----•--...._.............----------------.....----------------•------------...------I.......................................--...................................................... Date PermitNo......................................................... Issued-......................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH „ : ........ ��J/f� ...............OF......... 51"�t!YXQAL/.. ........ (Inrtifiratr of Toatplianrr THI IS TO .C-FW IFY That t+ Individual Sewage Disposal System constructed (-A0 or Repaired ( ) by...... / ...........-•-......f..' ryIns tiller ., n., at....lad-• ----�-. -.�.-------:-��------- J , _....................................................... -----------------------------------•----- has been installed in accordance with the provisions of T�`..,' ..5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No....... ..... .e7.__.................. 'dated_-../-•a.......f--C.)............... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE. /0..... �_.. -------------•..... Inspector.. ...... ........................... THE COMMONWEALTH OF MASSACHUSETTS BOAR -D OF HEALTH� 1 � ...............OF........ L� ...................................................... e^ No............ ........ ... ............. Disposal ...ork Tonatrndi-o-�n. rrntit Permission is hereby granted. --------------- ... !.......� 7E�.....,�..!....:----..._......------------....----..................---......... to Construct (�or Repair Q ) an Individual Sewage Disposal System at No.-/ ::. ' ...../.. ..... Cr' Street as shown on the application for Disposal Works Construction Per ' No.._:.v.... .... Dated... . _2..` ' ,� • Board of Health � DATE .... ..... FORM 1255 HOBBS &'?WARREN• INC., PUBLISHERS :z. i i F.FL, Ei-EV.= Wx I - FINISH GRADE _ (PSxl FINISH GRADE FINISH GRADE --- TOP OF FOUND. OVER TANK OVER PIT = r;Y` ELEV.:: &_1(.5 - u — GNIMIN NEY BLOCK "M"'`'•` _ a4 C.I. --- --" - 4^ V C. _ \ WttERE NEfiDEq BACKFILL , PEASTONE DWELLING - - - - -- a_V cJ� -- XL7 \ X= � G o s ° C 0 O 4 O 0 a(s CELLAR Iai.OaR 1 cv o GALLON `�4 . . • • � •• o O O O o�Y � 1/2 ELEV. REINFORCED CONC. O OOa 3/4� TO 1 ' CRUSHED STOME n o O o o ' d DIST. BOX " ` o O 0 O o /� A'tV �/ o a s o o O O o r'I , SEPTIC �/i �` ( TO BE LEVEL Q 9 � o o t7) � 0 o y� BOTTOM OF PIT AND STABLE) ° o O O o @ 4 (�(( ELEV. SYSTEM PROFILE _ N ( N07 "TO SCALE) LEACHING PIT DESIGN CRITERIA Nd&BER OF BEDROOMSfk = '3 r� r GALLONS PER DAY �� __^_ `�` 1(v0.O� GARBAGE GRINDER �oiy 17 TOTAL DAILY FLOW LEACHING AREA PROVIDED 2Q ~� 3 1 s I Eu.:m. t.. .e. r Kq x,.z5rc 2►5 -t-�s csPra ' ? �j 0 'T IL SOILS L.Q ZA! u Pt r r I(�DO .C)(::) t ' amp , L4 T • PROPOSED SEWAGE e , r s DISPOSAL SYSTEM +"JSKGTE PRC3P�JSED _EL L IN G D Btt :' - S { ' . DATE PlI Op1411'ttdN RATE`S-: OF y SCALE; AS NOTED �DAT� ry .. fcgn kit v SN kN :�►4 i: I�Y`v" i P ;— 1...f�T Si-1�i*a4f 1t1 CL.i4atrJ -TUP. 1 G,"t SHEE'7 hl , , 1" .�^,ssaN rn NOR111AN l, t4}SSINIAN R;L..S. iQ6r- jpma1�' 1lt ac<a ° rr�� 229 MOLLY- A'QtX F "AD S• . ♦A S 3 wf �.'�C �y 4.TMl 0. , .,r ,l- Y '"� + _, . •t,� _.. �'.'l' '9 7' .. �rx ..r n.• s M � «..... 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