The URL can be used to link to this page

Home My WebLink About0233 MARINER CIRCLE - Health Manner Cam �33 LOCH ION SEWAGE PE T Nam: / 6� O 83 L VILLAGE id 7U / INSTA LER'S NAME i ADD ESS j BUILDER OR OWNEII DATE PERMIT ISSUED DATE COMPLIANCE ISSUED / J � � � � � �o�T� �° a r� 7 �-� v �� ..� �� *� No.............. Fss.. r THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..... .........0 F... ......................................................... AVp irFation for Uhipoii al Works Tomitrnrtiun ramit Application is hereby made for a Permit to Construct Al).or Repair ( ) an Individual Sewage Disposal System at: ' - i� .. .... .--------------• ......�... ------------------------- A .......... ...... ...- .. .Locati..... . s ... �dr .... .... .......... ._ .._..._ . ......A.0.4 ................. ------ /� Owner a � .... .. ................ ......................................... --•-----._.......--•-------...-------•-•••---...._....-•-•--...._.._..._.....................•.... Installer Address Type of Building Size Lot... .Sq. feet U Dwelling—No. of Bedrooms................................ .....Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of persons . W YP g ---------------------------- P �..-•----•--._._. Showers ( ) — Cafeteria ( ) Q' Other fixtures ........................•.............................................. W Design Flow........S. .......................gallons per person per day. Total daisy, flow...._g_a.n................_•.....gallons. i WSeptic Tank—Liquid capacity� 2gallons Length_ . _._ Width...'v. ..`.. Diameter________________ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.........I....... Diameter.......7�_..... Depth below inlet.....-?........ Total leaching area.J.—�_�.._.sq. ft. Z Other Distribution box Dosing tank ( ) 1-4 Percolation Test Results Performed by....-,lo&- . 1 'S.--.. Date...... _ .. ......... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.... ._............... /lam Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a+' ••-••-•..--- -- 0 Description of Soil----LS._-3-•-•- b ..•----••-----------------•-----•••-------•----•......---••--------..--•----•--•.....---•---.........•---- U W ............................dl-_A5........ m1-...� --------------------------------------------......................................................... 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 TL iT::L 5 of the State Sanitary Code— The undersig d further agrees not to place the system in operation until a Certificate of Compliance has been i ued by the bo of heal ,(' �z ...J......... .... . .. . ..�,.----.... Si_gried Gl to ApplicationApproved By..........�-C-.......--- -- -- -----=-•-••••---------------•------------.....--•-- -----2... .. ..--..- Date Application Disapproved for the following reasons:.......-...................................................................................................... _ ............................................................................_............................................--------------------------------------------------------------------------..... Date PermitNo.......................................................... Issued-.............................-.................... Date THE COMMONWEALTH OF MASSACHUSETTS f" BOARD OF HEALTH r~ f. .............. .....OF.....>......:............................................. Appliration for Disposal Works Toustrur#ion Prrmi# Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: ......._.... _........................... ..... .......................................... .........._........._---------__-................------------ -....----- Location-Address / / or Lot No, f i 0 / �I f Owner. / Address /'. /s �_...... . ...._ ............................... Installer Address Type of Building Size Lot...._.7�K.!"/-2(=' Sq. feet V Dwellin No. of Bedrooms..................:.........................Ex anion Attic g— p ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons.......`J......._..._..... Showers ( ) — Cafeteria ( ) dOther fixtures ------•------------------------•---•-------•----•---........--•------------•-•-----------......_...--••-------------------...._..-•----...........---- W Design Flow.......... .=`?...........................gallons per person per day. Total daily flow---------fln........................gallons. WSeptic Tank—Liquid capacity2. gallons Length.Z.' Width..�Z._... Diameter................ Depth................ x Disposal Trench—No. .................... Width_...._...._......... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..__.____._�_.____.. Diameter....... ......... Depth below inlet___ .___��.._..... Total leaching area._.??t..�...sq. ft. Z Other Distribution box Dosing tank ( ) ,f� '"' Percolation Test Results Performed by �I�"....._�*.!`:�_�-?+.±-"-�._._. Date_____ :a � r v Test Pit No. 1•...............minutes per inch Depth of Test Pit.................... Depth to ground water..._:; ............... fx, Test Pit No. 2................minutes per inch Depth of Test Pit.......•............ Depth to ground water............___•--___-_. -•----•--------------------------•----•--•------••........................................................................................................ O Description of Soil.... ._:__=S______1�?:r-s -------------- ---------------------------- •-----------------------------------_________----------------------------------- U --..._..---••----------------------.--•--J..--•---'`1'.. 1�. ..... UW1. A5— ")/ ....--..� -f t----••---------------------------------................................................-................. 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 TITLE; p 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 the board'of health. Signed.:....!fs -* ------------- Date Application Aproved BY --- _ •-••------------- Date Application Disapproved for the following reasons:-------•-----=---------•----•-••----•-----------------••---•---------------••--•------------------••-----....... ---------•-------------------•-------...------------------....------------•-----.....---•--•-------•---..._.....-_.............--•------------------------------•-•--------------------------------_----- Date r"'Permit No......................................................... Issued--=;---•--•---.......................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1 f •.' .!:�.n..............OF...... �.<...r?J. 4.....LS.�::....................................... t f9rdifiratr of TompfiFanrr = F THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) ..r s�... f/_... ,1�..... „-/� -----------------------------•------------.....--------------------.....-•-••-•--._......-------- by....---••---- -------------------I 1.,-- -••••• - 'r_ ` 1 // Installer �� . /> at..._....; ---/: 111a I e ,F u ( .0 l /1 f,..� ,/ /C. /"/ "-, .. f The State Sanitary Code as described in the application for Disposal Works Construction Permit No. !. "- r ,j --------- dated ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.. 61...Z.51ff...... Ins pector...... '��-. -•--••-------- - ------........................ THE COMMONWEALTH OF MASSACHUSETTS �.- BOARD OF HEALTH f/�1:. t.f'...............OF..... ��!..-......:.�i_/l ,F t._>!. ... ---...••----......•-••••••........ No......... �f FEE. ............. Disposal Works Twonutrlttiun rrrmit , Permission is hereby granted....._!r{.. ....r.:...:.,..._..ft_��.1tf " -. ---•---'•f�--------•--.....-•-------•................ to Construct OO or Repair O an Individual Sewage Disposal System / at No.. / 4 -- .... 1l/ lr... *'�i - �'�- r,,_� /•�4_1 . ` Street as shown on the application for Disposal Works Construction Permit Dated.__._1�.. , "' -- ......................_ =- jf 7~ /gip.................. .. Board of Health DATE..- ,Cf ................ -- -f- f/ -•----._...-•---•----- FORM 1255" .HOBBS & WARREN, INC., PUBLISHERS u.. s., R `S F.FL. ELE'v.= II'1 FINISH GRADEE � � `a�� FINISH GRADE FINISH GRADE TOP OF FOUND. ,.z. OVER TANK = = + �� OVER PIT O ELEV. v GlfQ u C.I. CH� �.,`EY BLOCK p _ a _- 4 4 V.C. WHERIE WEDEo BACKFiLL • 3�� f'EASTONE DWELL I N.a ________— 14_V C I. v �rt• C V O O V 4 O l 7 r CELLAR FLOOR r'o i6Ord GALLON % o , ao O O O O ° 3,/4" TO I-1/2° ELEV. REINFORCED CONC. - O O U Q o •� CRUSHED STONE •( o . t t ' ? _ . DIST. BOX bo . o O o O n� ► a ,,o. r e ti 4 1 d O 0 . Q o SEPTIC TANK (TO BE LEVEL t o O O O' o o� e0T70wA OF PIT AND STABLE) ° ° 4 !v ELEV. . SYSTEM PROFILE NOT'To SCALE) - LEACHING PIT DESIGN CRiTER14k o N-UMBER OF BEDROOMS GA PER DAY ,�2;il! � Pp � 7"a� = GARBAGE GRINDER -_�_ �Ki 'S.�E--- `� .�r,L, -,• F7 �" TOTAL DAILY FLOW LEACHING AREA PROVIDED � . boa to IC I��4 G �l) - SOILS LOG ON ELEV. r- -� ,s 0 PROP 0 SED SEWAGE DISPOSAL SYSTEM PROPOSED DWEL L IN6 1 NSA G T E D B'f+ „�y'�.s�;•.. 's.. �f'� � ._. - - -- - ---�.�:------�__ DATE MASS, PERCOLATION RATE WN./INCH_ SC41_AS NOTED DATE t\IA--T 10S 1!% 4=&4 M-_-S".CA r'..1" NOR AN �4��'N 0, M G>=oaa< AC ¢.,-s: LC rr SHOw N Of-3 0L#4Q -AtUnE 1 ,67 S►+E ET �. 2 � G z4 c,�.s- o J' ' - F 'Z4 N+f2t. g GROSSMANSMAN 5c. �-a-i b,r.-a-I 's.-* -.Cx 1',a"Z'• '� l Ell+ 5�-!O " ,�� 1270 . NORMAN GROSSMAN PE, R.L.S. �o -' of�• C! .E'.�Ll, E 'StW-O 226 MOLLY POfNT ROAO NAt CEWTERVK LE, 1MAS9: ' a .w _..c� T' .L.... ...JS-r:' o- A ._. ¢•+c .-'�',.tG 'L . .f'f' .` - -