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Home My WebLink About0209 MARINER CIRCLE - Health C rOI)q f n ram' G rc,/,2 o z � -da y 'FEz.............................. No.0_1q -7sl THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...OF..... ................................ Appliration for Uhipasat'Norks Toniatrurtion rnmit Application is hereby made for a Permit to Construct (N) or Repair an Individual Sewage Disposal System at �, 1 ww,�,,X ./ , ...... ... .......... . ....... ................................................................................................. Location-A rs or Lot .............................. .Z7 ................. ...................Y.......a, Installer Address Type of Building Size Lot..40,.e,-d ...Sq. feet U Dwelling—No. of Bedrooms .......Expansion Attic Garbage Grinder '_l a of persons........6.7............... Showers Cafeteria P4 Other—Type of Building:Zvil. t Other fixtures ..... -;ao -------------- ------------.................................................................................. ;P- �----------- ---------------- - Design Flow.............. --Z?_..-5.____gallons per person per day. Total daily flow..... ......................gallons. 1:4 Septic Tank—Liquid capacity/OZ.Vgallons Length,4._�X... Width...V��--- Diameter-------_----_ Depth................ Disposal Trench—No. .................... Width... .... Total Length...................V Total leaching area.......-; :4 ft. Seepage Pit No ..... ...5a, -----/....... Diameter......0......... Depth below inlet..... ............ Total leaching area !r Z Other Distribution box Dosing tank Percolation Test Results Performed by---------/6 • .........F......... Date... 1.4 /- ----------------- f---------------- Test Pit No. I................minutes per inch Depth of Test Pit---.--.............. Depth to ground water.--..................--. PLO Test Pit No. 2................minutes per inch Depth of Test Pit.---................ Depth to ground water----.................... P4 ........ 0 Description of Soil--..!2........ .................�!.................... ---------------*-------------------------------- ... ,V�-------------------------------------------------------------------------- ................ --------------:....................................................... Nature of Repairs or Alterations—Answer when applicable............................................................................................... ....................................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with let---/i,5c-e the provisions of'JILT,LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has Abeen ' ed by t oar of h .Ith. S' n e .......... Date U-4 ......... .4 Application Approved By................... ...... .... . . .......I .............. ......... .. 4--------------------- ..._12... ..... Date Application Disapproved for the following reasons:.............................................................................................................. Date PermitNo......................................................... Issued_....................................................... Date No................----••- Fps......... ............... - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..... ....OF..... --------------------------------- Applirution for Disposal Works Tonotrarction rranit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at•� / • j r� ... /(.....jr is^f ( ,/ iX L ✓$'t Location-Ad ? or Lot No.�t7�I .. ..... 6».. PQ Installer Address UType of Building Size Lot.; . _ ....Sq. feet .., Dwelling—No. of Bedrooms. .........................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building d6or_lze of persons.......6................ Showers — Cafeteria P4 Other fixtures r W Design Flow..............I...__.__._. , _...gallons per person peay-------Total daily flpw..__.��.?..30_._.____.....---------------_..__..__gallons. /� WSeptic Tank—I.iquld capacity . . __gallons Length......... Width._.a.... Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length..........;......,.. Total leaching area....___-.-•-------- q. ft. Seepage Pit No----------/....... Diameter......X..._..... Depth below inlet...-7...X_.._.. Total leaching area. �qA Z Other Distribution box ( Dosing tank ( )� '-' Percolation Test Results Performed by.........Al%�G�'-!��.....:....... .............. ..�. Date..��y�_..��...... Test Pit No. 1................minutes per inch Depth of Test Pit.____._------------ Depth to ground water........................ tZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ...............------------------- = ........... r/ ----..........` ...................................................... 0 Description of Soil. - - ��° ......dG ,f,'' / ,tug vd x ---------•-----------------------------------------------------------------------------------••--------. •---•--------------------------- .......................................................... UNature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: "�.. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with !'1T/71x�i the provisions of ..i�.,,-,E 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 oar of health. = ;H. S' ned_ ' ._ f Date Application Approved By---- A. ....--. !! --•--•--------------- ....../Z --- - Date (+ Date Application Disapproved for the following reasons:.................................................................................... -------- .._... ........................................................................................................................................................................................................ t Date PermitNo...............................1....---•--------------... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF-_hi ._,ALTH OF... 1'G' "j.` '?::. ._..................................... (grrtifirate of Tomplianrr THIS IS TO_G� TIFY, That the Individual Sewage Disposal System constructed ) or Repaired ( ) b ;r`- +,e,.; :4t=�¢ r� ----- --------•---...-•------------------------------------•--------. Installer at. `= has been installed in accordance with the provisions of/Trllx of The State Sanitary Code as described in the application for Disposal Works Construction Permit No. _*__._ ................. dated......//- _n?1..................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.. 1 1.1 : l............................. Inspector.................. ..f_.... .....----- ..................................... THE COMMONWEALTH OF MASSACHUSETTS ----'""� BOARD OF HEALTH r 7 v?! '� '-' ........OF...... -.!.r..r�.._ r ..`��e.. n-�l No......................... FEE..-••••................. Disposal Works Tonstr tiara- .rrmit. Jc �Gt C........./ c. , � Permission is hereby granted---- .............. .........•-..•-.-----_----- _._ . '. to Construct (,">/-) gr Repair ( ) an Individual Sewage Dispos Syst - atNo.................... .... '4f-t=' f L-L -------- ... %._ ._....._._......... .............................. Street as shown on the application for Disposal Works Construction it Dated....//_' ................. � /7 Board of Health DATE-------- ! ;.. `'FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Y I - L �.01 CAT 0 SEWAGE PERMIT NO. VIILAG & _7_ INSTA LLER'S NAME & ADDRESS B U I DER OR OWNERlei G DATE PERMIT ISSUED DAT E C 0 M P L I A N C E ISSUED y9 q3 33 y�- 3 y3 F.FL. ELEV.= (. I FINISH GRADE FINISH GRADE FINISH GRADE--- TOP OF FOUND, OVER TANK = G5X. OVER PIT ELEV. - 7 )(6, .n lr f 1 CHIMNEY BAC IL.L PEA T , T tF I 4" G.I. - 4" V.C. Wt4ERF NE oK - - STONE AKF � 7+' DWELLING - --- -- 4 V.C_% �.,.. ___ _ 0 O GALLON _ o (D (� o t 3/4" TO, 1-1/2" CELLAR FLOOR a v � ' O n o ° CRUSHED STONE ELEV. _ k5 . REINFORCED GONG. c I r1 to n O Q O o '-- .' D1ST. BOX � " o y i o Cl 0 p y y iTO BE LEVEL j i , ( c f, 0 0 BOTTOM OF P',T SEPTIC TANK AND STABLE ) o C;� C o ° E.LE . = S4X�S SYSTEM PROFILE I NOT TO SCALE) LEACHING PIT DESIGN CRITERIA NUMBER OF BEDROOMS GALLONS PER DAY _________._�, •�-� � ; GARBAGE GRINDER TOTAL DAILY FLOW { LEACHING GREA PROVIDED =_�__.��:- - \ J F i �c S►17��c A i_L �p -s r to 7 f:K 4- 9 7.Z5)tf Z.5 4 5 5 G P a 2 °'I 3�GF�DL55b GPDC. Titr SOILS LOGrj -rl-J K � ON ELEV. =-44y2c - 0 ), �S P I T, r I CIA!) c d Y _A? PROPOSED SEWAGE DISPOSAL SYSTEM s mbpEGTEO BY� *"A.x � ,�.�.:j-e,�.�. ed. 4c t_T►s PROPOSED DWELLING -- DATE �` '* 22 } � '�_ - _-_ .� MASS . PERCOLATION RATE VMiN_/INCH _ SCALE�AS1y0TED uATE QC,T r`71d`�179 OWNED BY , �'aS� , -g c�(�E �nn'1 5��r✓'F:7 G• � ��~'`EGG �''�' 'C�`GJ, ._'--I,•' ,! ¢:: :�='. 'd'�` !'..�,•r°' ,f.�, rt , �Y F . tr NORMAN r - --IL{oT ! F c. r� t-'4 �A i..� n°,' S GROSSMAN nJ�',iR1': _ :-law i,;-t- C � .v. �:4Kv ` " A� �0 NORMAN GROSSMAN PE , RL S .A 226 HOLLY POINT ROAD �stE w t- �x� Sr. Cr� .�`tir�. �✓ — --" (��S�r ;Ey�` OSSlONALE�6` CENTERVILLE . MASS .