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HomeMy WebLinkAbout0221 MARINER CIRCLE - Health ,2d1 /Yl A�t her L O CATION aa� SEWAGE PERMIT NO. VILLAGE � (9 7"' T INSTA LER'S NAME & A DRESS N U I L D E R ON ^ OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 9 p ' a 14ou sE,:: r ✓C- � S 7 -7- No................ Fps.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF...A......:....�'� :............................................................ Appliraation for DhipasFal Works Tomitrurfivat ramit Application is hereby made fora Permit to Construct or Repair ( ) an Individual Sewage Disposal Syste/m�at _ ... .......... . Coca res or Lot N o , ....... .... ..._ ner &tir s a Installer Address - ---------------------------- ....------.....-........-..-..:.----..-..---- L .... Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion,Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons....... ................ Showers — Cafeteria Q' Other fixtures ------------------------------------------------------ W Design Flow....... ` ...............gallons per person peF day. Total daily flow.......3..��_.�.....................gallons. WSeptic Tank—Liquid capacity >.gallons Length. ... Width.. __-k� - Diameter---------------- Depth................ x Disposal Trench—N - -------------------- Width....._ ............. Total Length.................... Total leaching area....................sq. ft. .. Seepage Pit No....... ........... Diameter.......Xj...._ Depth below inlet._.�3..... Total leaching area............___._sq. ft. Other Distribution box ) Dosing t Z Percolation Test Resules Performed by.....� ry �`�:... ._.... f ........... Date. ......�............... aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to groun water--- Li, Test Pit No. 2................minutes per inch Depth of Test Pit..............._.... Depth to ground water........................ •-------------------- ............... ........_.... --------------- -------••---------------- O Description of Soil...... - = x ---•-- = .... W ...................-...............................................................- p ---•---------------------------•-•-•--••-•......-•-•-•- VNature 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 TL1'i,;. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued by bo.rd of health. '�v e• .. . . • __:� .. .. -------------------------------------- f ....... --De Application Approved By.....--•--447 .•. • • ...... ................................ ......`..... 7f............ Date Application Disapproved for the following reasons---------------------------------------------------------------•---------------.....------..........--••-•...... ..............................................-...........................................................................................................................=------•••--•----••--.......... Date Permit No.__._.... .. Issued.... .....................•------•-------- Date 6)23�. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF 1-i-E-T H �.................OF..:, Allpfiration for Disposal Works (fonsirurtion Vantit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal Sys / , - �� . - '� = ...... ......... r. :�': .... Locatidyes or Lot``J __::4� -•--. -_-•............................ .---........•-•-----------•------...._ ..... Installer Address Type of Building 3 Size Lot.................... ......Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons......l.................. Showers — Cafeteria 04 Other fixtures-------------------------------..........--•••-•--•--•.•----_... w Design Flow.......... ..................gallons per person per day. Total daily flow....._.3-2-._0._..._........__._..._gallons. WSeptic Tank—Liquid capacity/_?_.gallons Length/.__a.... Width..!/..:v... Diameter................ Depth................ x Disposal Trench—N9..................... Width.................... Total Length.................... Total leaching area_...................sq. ft. Seepage Pit No_____________________ Diameter...... Depth below inlet..,7...3...... Total leaching area..................sq. ft. Z Other Distribution box ) Dosing t ( ) � '-' Percolation Test Result Performed by........ ' _i�" '..' >': _!t���........._. Date_ . Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.. �,L_-, (s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-. ___.._..__._.._.___. a +V-------------• ................................ •........................ --------- -----•--- -------••-•---- '�-�� �.c� r; ! ...--•----....--•• -------•-••-•--------- x �..._.� �, 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 MITI. , 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued by e bo rd of health. `esr/ .............. y f "D _.....Si Application Approved BY ~/le ----•---•-•- Date Application Disapproved for the following reasons:................................................................................................................ ..-••-•••---•-•••-••---•..........................••-•••--•-•.........•-•-••-•••-•---••-•-•-••--•--•...•••-•--•••----------•-••---•-•-•--•-••••••••-•-•-•••-•••-••-•••------••---•--•--••--••-•-•--•---- Date PermitNo......................................................... Issued_........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA .........OF/�? !•C.i............................................... (9rdifiratr of Tontplinna THIS IS TO CE- � �That th ndividual Sewage Disposal System constructed A or Repaired ( ) , '�(%- C... ram/ J by.... _....... - %. .... ........................................ -•-----__---••----------- �r/ r Installe� -•--- �.. •- ....-- has been installed in accordance with the provisions of TtTIDE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No . ...._..�t................. dated__..-1/_-./._"' _..___...____..____._. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................. Inspector..............................................------- ........................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA No.....:................... FEE.." .f ........... Rapia,� zl urk dun #r in Vrrntii Permission i hereb anted. / �' '�... [v� !`-�:=�'' Y to Construct ( ) o/r� Repair ( ) an Individual Sewage Dis osal Sys ' L - ........ - - - - -------•------------------•-------_ -----.--------------•----••-----•-----••- reet as shown on the application for Disposal Works Co struction mit , o................... Dated..... _ 1; Board of fealth DATE........ ............................................ . FORM 1255 HOBBS & WARREN, INC., PUBLISHERS - F.FL ELEV.= ,� I -� I N t S H GRADE r tit erut�E FtNrsN QRALtiE TOP Of FOU14D. � ovtft -tAws for"eq OVER PIT = Co 14U jL rT I - - 1 Y *LOCK SACi(FILL 3" P£ASTONE 4 (,.I. Wf Vrii�ltE NEE Dao EL 1N8 — v.C1 0 O o d i / Vt>' f + �� ♦ e + •� e_ O ,a a v I 4 O 0 o o 9✓4� TO 1-I/2 CELLAR FLOOR __L GALLON b REINFORGEO G©WC. a t l� o O 0 Q o • ,� o CRUS14ED STONE �..•.y f y j � � 'i o O CO oT. [_ BOX M o --' e 0t O 0 .0 0 VJ d �._ �►= (TO K LEVEL 4 3 0 . p p 0 p o P a \�. BOTTOM OF PIT PTI C TANK � � •.••-•.••• AND STABLE) © o O 0 O o ° 4 ELEV. a�1Y2S SYSTEM _ PROFILE HOT TO SCALE t L.EACH l Ng PI T ^� D 1 N CRITERIA ,. 1(00.00 GALL DNS f-E R DAY - a • rorAL DAILY FLOW LEACHIWARE:A PROVIDEO "7.. 4r�L�! olk r �� �� © { d �Jllx ©. �� ,� ; � - . ..� -•.,,r,,`�� yam,f.. eox .u,i LA 49 4: PIT '� `.:;)CA.Lt:- , t r: o PROPOSED SEWAGE A . DISPOSAL SYSrEv PROPOSED DWELLING v��_—_-----T- �M 62--r��,- MASS. .f" / t�LA;TiON RATES iN1'! !f SCA�.S NOTED DATE • IE:L.-E'V�-'`C'i+p�.�'y e�+:� l�tt�>_ t��►.Tt.�+.� �..f„�,.,,�n�� , '��� � �� - � � , 2 _ L,< --r —Z."G V M Ors P LA,00 -Tub 1.40 S►-I«EE-t' h to, :�: ,r' rro a t Ai ',� «' r` 4 L EA.T PO+��� i�it V F- a 4- '„�-{' i h.l � � �-.�i D C CkQ ; KA„ V T � `� R . ?5 j l•;yT 3- t�+ "` SG�k� "a- ,fie' �+� , �`. ;i NOf7mAl- b'14flSSMAN PE, R i 5.- 4 P� i i. tf� ar: �,,,-Qes x O A �, t�. �`�k •�.'� i` i f 2 2 O�6 HLL.Y P�0 l N T ROAU a )t t 't �'XJr.3 S"G ;.ate•. . 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