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Home My WebLink About0021 MOORING DRIVE - Health C�d�— 0 23-0sy LOCATION SEWAGE PERMIT NO. a V I L MCI- IN _. STALLER'S NAME' i ADDRESS v BUILDER OR OWNER DATE PERMIT ISSUED 7- i�_ � DAT E COMPLIANCE ISSUED ! s w I No.......: Fic$.... ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD F 4HWAi-� I..l!'�'jU.................O F..... ........------.................... ,Npplirafton for Bispiiaal Works Tonstrnrtinn Urrmit Application is hereby made for °a Permit to Construct A or Repair ( ) an Individual Sewage Disposal Sys CII].1� ....1..% •L.......r.......d.r......'�.�...f......`.. C ./�% . s.. - ............ ...... or Lt No...... ... o ..... .. ... .«...... .......e .. . ............................. ................... e.__... _ .. ............................_ wner ess W Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms._...._.._ __---_ _----Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building, ..... No. of persons.......4................ Showers ( ) — Cafeteria ( ) dOther fixtures ---- --_-_------_---------•-------------------•------------------------------------------------------------------------ W Design Flow.................6._ ................gallons per person pier day. Total daiilY flow.......330........................gallons. WSeptic Tank—Liquid'capacity/090..gallons Length.X..... Width...441..... Diameter................ Depth................ x Disposal Trench—No. .................... Width.... )_ _____..._ Total Length.................... Total leaching area..__.........�sq. ft. . r � Seepage Pit No..._.___.__I..__.... Diameter._____.: ... Depth below inlet............ Total leaching area..SN.....sq. ft. z Other Distribution box Dosing tank / ~" Percolation Test Results Performed by..............:. ,d.L .. ✓-_._ ........____. Date........................................ ,aa Test Pit No. 1__......___._._.minutes per inch Depth of Test Pit.................... Depth to ground water---_) ffz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (� -------------------- -..... ----•------------------ --•------------- -..... ..... ......... *.... -..... ---------- O Description of Soil.. "' ....._ x e_ U / W �`�"/ --sue ................................................................................................ 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ' sued by the d of 1 lth. 0-21 S' ned.. •........................................ .. f�. ate Application Approved By----- ;rj -----:. . . ..... .............. ..................... -•-,..."'....J7-- Date Application Disapproved for the following reasons ..............................« --••-----...--•-----------------------------•••----•---•-----------------••---•-----•---••---...-•-......._..............•••----•....---•--•--••••-•--------------------------•-•----•----------•-••----- Date PermitNo......................................................... Issued-- .................................................. Date NO...........r 4 Fim ... ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................. ...... ...............OF...... .............................................. Appliration for Disposal Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ................................................ .e............... ..........I....... _2 Location- Add 14- or Lot No. ..................se. ................... ................OwnerT........ ................... "-Address _ .......... ......... Installer Address U Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............... ..........................Expansion Attic Garbage Grinder 4 04 Other—Type of Building,11 ...... No. of persons.......&................. Showers Cafeteria 04 Other fixtures ........................................................................................ ............................................................. Design Flow.................. ..................gallons per person per day. Total daily flow....... ........................gallons. 1:4 Septic Tank—Liquid capacity/P612...grallons Length.j.. '! Width_.4.1/4-1....... Diameter................ Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......... -------- Diameter........A!..... Depth below inlet..... Total leaching area..S7,�,_�sq. ft. Other Distribution box Dosing tank Percolation Test Results Performed by.................;6�2 ........................................... Date_ Test Pit No. 1................minutes per"1'n'c`1'-D-eptl1--,,of,Test Pit.................... Depth to ground water Test Pit No. 2................minutes per inch Depth of Test Depth to ground ........... .................................................... ------- ---- --- ------- -----------**--------*"------------*.........."............. . 0 Description of Soil....or;�-ZkZ..... U ................................ ...... ........................... ................................................................................................................... ............................. .............�M�.......................................................................................................... U Nature of Repairs or Alterations—Answer when.applicable............................................................................................... ...........................................................0............................................................................................................................................ Agreement: ' 1 0 The undersigned agrees to install the aforedescribed"'Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned fmilier agrees not to place the system in operation until a Certificate of Compliance has been issued by the boafd of health.', d ...... .................................................................... ...X a t e Application Approved By.... .......... .... ..................... Date Application Disapproved for the following reasons:.......................... ................. ............. ----------------------------- ..........................................................................................................................................................................------------------------------ Date PermitNo.........................I...-,......................... Issued...................................................... Dite 4 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............OF... L ......................................... ...................... (9rdifiratp of'Zontpliattrr;': THIS IS TO CERTIFY-Tha_t-the Individual7Sewagisposal System;;pn§tructed (r- or Re paired( .. � � _IZ; Z' Z� . Of � •- t I,- ..by......- ....... � ...... �........l........ ....................... .... .. ... ....... —4 Installer at...................................... ---------------------------0---Z7-------- -------------------------A ---------- has been installed in accordanc e w&Fthe provisions of T! 5 of The State Sanitary Code as described j"n the application for Disposal Works*Construction Permit N� ..... !�17................. dated-..?------ .... ---------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS ED AS UARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..........J/- -? dk6j ......./...................l...................................... Inspector----. .......................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD_OFHEALTH ....... NC; .... .........._OF ................................................................................ FEFZj�........ Disposal-Vorkp Tonstrurtion 1kruttit Permission is hereby granted................................................. .......................................................... ............................... "44 to Construct (X, ) or Repair an Individual SewaF.-Disposal System at No......22��...�1)41--7-11.4, / 1.011,11^r , /161A, .................................................................................... ..................................................................................... Street as shown on the application fo/Disposal Works Construction Per np-310-------- Dated... .. ...................... -- - -----------------------------ol� DATE.. ............................... ............./ Board f ealth ... ... ... .............. FORM 1255 HOBBS & WARREN. INC., PUBLISHERS .,,.r < - •� _.tom. .� • Y, 411 - r �, :.,,.. tiro_. 'r. ,.r;', o-.a:. v .1 1 S�'•,p ham ♦' -., , t L J N 4 , , r F.FL. ELEµ.- UX2 fINISH GRAOt4gxa FINISH GRADE FINISH GRADE TOP OF FOUND, •- OVER TAALK �-Ap OVER Pt'i = h7X S s E L1EV.. c"wmcr OL.00K BACKFtLL 3" PEA3TONE raw I IM == 4. v; 4^V.cJ� wt"c "wow yX`I v d o c O 0 O o o d CELLAR' FLOOR ._ GALLON • • • •• 0 Q O o v 3/4" TO 1-1/2" ELEV. REINFORCED GONG. - b 6 o O Q O 0 ; ° 4 , CRUS14ED STONE O Q p ci i d 4 c o O O n A D I S T. BOX ; 7 0 0 0 o O , sf a • . o o Q o (TO BE LEVEL V o O o o o ° �Y BOTTOM OF PITSEPTtC TANK oAND STABLE) O O O o 7 ELEV. �. o�, SYSTEM PROFILE ( NOT*TO SCALE) LEACHING PIT DESIGN CRITERIA NUMBER OF BEDROOMS _ LOT'//Z GALLONS PER DAY R GRINDER GARBAGE GR E TOTAL DAILY FLOW nt I LEACHING AREA PROVIDED= Nj Es 4- G7� A"'r 69x �y SOILS LOG z, on ELEV. _ 6 X-7 68 �� \ .B.�'' 7Amt, l ' \X \ - >i PROPOSED SEWAGE szxs DISPOSAL SYSTEM INSPECTED BY: ZLIL /'-L-c PROPOSED DWELLING DATE : 7 t: l MA PERCOLATION RATE MINJ INCH DATE SCALE: AS NOTED /I/0T` / . �4�I//1 */�C� 5 �/II /t/I S,L /ii (J/�// �' %"'��.�c'y. OWNED BY D7-�f�OC.�jn/ ",-)AI ye 4h� r' 7�i�c' /�7 ;� L : N�=::.� �._�.�� ✓_:_ �'D�n �� , , 7' A/0' _ NORMAN GROSSMAN PE., R.L.S. ✓RJR r/� JI 226 HOLLY POINT ROAD CENTERVILLE, MASS: r