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HomeMy WebLinkAbout0909 OLD POST ROAD (CT & MM) - Health 909,Old Post Road I k t:our , Comic A` 074 - 012 _ --�_ '�1 qoHE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Application is hereby made for a Permit to Construct or Repair an Individual-S-6wage sposal �S_� g e Di posal/) System at: C4 Type of Buildin Size Lot.30�.AOA��_Sq. feet Dwelling—No. of Bedroo Z Other Distribution box Dosing tank Percolation Test Results Performed by......... ...........'.ft Test Pit No. I...4��minutes per inch Depth of Test Pit----JAI— Depth to ground water........................ '---'—',' —___—' Agreement: S L O C A T iON. :::� EUW�-" E PE RM�TNO. PILLAGE 9r�P� L---� � 1NSTA ER'S NAME i+ ADDRES ' S U I'L D E R OR OWNER fEv G , V.iLc4gr ` DATE PERMIT ISSUED DATE COMPLIANCE ISSUED r/ . .. � it ,` No.li Fx$. ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. . ; --'• -- OF...................:..<....:..-....-.. ---------------�---... .6=-........ Appliratiou for Diopou�al 30orko Tonatrurtiou Prrutit Application is hereby made for a Permit to Construct ( '() or Repair ( ) an Individual Sewage Disposal i System at: _ .... _ .... ..... .... ..:_.... ................... ......................... Lo t o� -p8ress—b or Lot No. Owner Address W •---•--•--------............---•• .................................................... ry Installer Address Type of Buildin Size Lot.....'>>_:_ ,_< _ .._Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) P-1 Other fixtures -------------------------------------------- W Design Flow............._ ____________i�______gallons per-person per day. Total daily flow.___._.______._ ________..gallons. WSeptic Tank—Liquid capacity G?! gallons Length._�_)..:_!a_._ Width.`�___`4?____ Diameter________________ Depth___)..::'I_. x Disposal Trench—No_____________________ Width___._.__`_._..____ Total Length.........._..........Total leaching area..........______. .sq. ft. Seepage Pit No..... Diameter........ Depth below inlet...... Total leaching area___ / _ sq. ft. Z Other Distribution box ("T Dosing tank ( ) I f l:.e� 7 "- Percolation Test Results Performed by......... s_-� � .- j j ' __"_.�_ ----------------------------'--"-/:.(t----`--1.�_�. ,Date---------------= -----__ aTest Pit No. 1__-4::�.Z-._.minutes per inch Depth of Test Pit.....14..f___ Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ------- -----------------•-------_...-•---•--------•---•.................. •••••--••-••-•.....••-••-••••---•-•••......... _-•••------ --•-- n -3 r ,��I t > .a� O Description of SoiL(:�...'- .I;,�t:: �?��::---•--�------=-U=--............-----------------------••---••------------------------------------------- => - fit_N �. at,ti' ..............................�_. ~_ "► .................................... =' 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b en issued by the board of health. e ...............................•-----•••---._....._..-----------------------•. ....... _.._..._..._e Application Approved _r" _ _i° '___ __;, _ f Date Applica approved or.t l yo�"zn reasons:_____________________________________ ...._ • -- ........ . - ----- = - ''''` '------------ ------------------------------ Date --- Date Permito......................................................... Issued_...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... CIrrtifiratr of ToutpliFanrr THIS IS TO CERTIFY haf-the *vidual Sew osal System constructed (". or Repaired ( ) by..._... . / .: . J �/ I,nst ] •=-at. ----- --•------•- :_....1...... -- ------ .......r-----....--••-------•----------------- has been installed in accordance with the provisions of T L- o e State Sanitary Co . as abed in the application for Disposal Works Construction Permit No._ )� .__________ datedf__`_. _ �. { THE ISSUANC OF THIS CERTIFICATE SIiALI. NOT BE CONSTRUE® A GUARANTEE THAT THE SYSTEM �,F TION SATISFACTORY. DATE---••-- ••••-•` = .................................................. Inspector__... . THE COMMONWEALTH OF MASSACHUSETTS BOARD OIF7 HEALTH L ... a� NoF........... i.... FEE._C...Y................ .Biiipasal Vorkv Ton urtion ranfit ,r Permission is etr ranted --••- - --• --1�! v- L /........................................ to Construct ( pair ) a ., �1al 'e ag ?�posal stem k Str t , '.as shown on the application for Disposal Works Construction Permit No................____' ._..... ..................•------ ----- .......................................................... ard_of Health 4mT DATE.__.....= taC `--------------------------------------------........ FORM 1255 A. M.'SULKIN, INC., BOSTON - . __ -�-'-- --------*-- r----—.�.� I }ZODF•t FLo OtL y iA ll'S C-EI1..11-•IGtS { . - .. —. ._ _... •'I JiCJ_i� ..:�:BLV�DOAaI?�KBW1bV6-T�T-�E : I h � .`I. i ' t .zon-t-::.py�pL•f.51••loo•fN.__. --- _. — _ Sfc,.M _. mcOmfQ XT WTILE--- � . - I -1 :Y I ' I S. YO. f'�..LK 113 C}p1t S�•M 6ba - - _...-_. .. ---..... ........._'( _ . 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Ewe :-.: � r I I I wlw.ow c A&M SDRUdA You ri 11 IJ 1� it - I -- .i I I:yP 'TH.. 4:F�1 (, FULL /r � •iE8 .. NBW� !.g>rw, .,�- .�. .. ,.Iea r/a> � - W�oVFJ•,.' <�=III - to Exrf•.'. .... 11 =1 f-e..8;.'K�:r_. . '. =ql AiI EL7( 1 QC� FIIe.T FIL ��f�l F (�lC, kt�l.. Lgyi PL,iZc�p�IT I NOIE -..9bq ;.v1e s i - � 20 FT MIN. N TOP OF FOUND. (jNCRETE CLEAN SAND PIPE - MIN PITCH CONCRETE COVER 2" LAYER OF PIPE - MIN. PITCH 1/4" PER FT STONE 10 ELL DIST EL Lu OCATION MAP BOX T_ WASHED STONE LL PRECAST LEACHIN SEPTIC 4,3 TANK PROFILE OF SEWAO' E DISPOSAL SYSTEM 0 TO DESIGN CALCULATIONS SOIL TEST NUMBER OF BEDROOMS DATE OF SOIL TFST GARBAGE DISPOSAL UNIT.. WITNESSED BY TOTAL E!77TIMATED FLOW REQUIRED 3EPTIC TANK CAPACITY. GAL OBSERVATION HOLE I OBSERVATION HOLE 2 ACTUAL si7E OF SEPTIC TANK... I S"00 -GAL, EL E ViA7 ION ELEVATION LEACHING AREA REQUIREMENTS LEACHING CAPACITY BOTTOM SIDEWAL GAL. RESERVE LEACHING CAPACITY . GAL, NOTES I ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E Q E "TITLE 5 AND THE TOWN OF RULES AND REGULATIONS FOR SUBSURFACE DISPOSAL OF SANITARY SE WAGE 2.COMPLIANCE WITH ZONING REGULATIONS SHALL BE DETERMINED BY BUILDING INSPECTOR OR BUILDING BUILDING SETBACK REGULATIONS PER BUILDING COMMISS10NER INSPECTOR OR BUILDING COMMISSIONER 3.EXISTING AND FINAL GRADES SHALL REMAIN ESSENTIALLY MIN. FRONT SETBACK THE SAME MIN, REAR SETBACK MIN. SIDE SETBACK APPROVED BOARD OF HEALTH DATE AGENT PROJECT LOCATION LEGEND SCALE7 DR. BY: DATE : EXISTING SPOT ELEVATIONS 0 OX0 EXISTING CONTOUR 00 %108 NO APPD. BY: REV.; FINAL CONTOUR 00 R J O'HEA RNY INC. DRAWING REG. SANlrAR14NS SITE PLAN SOIL TEST LOCATION RE6 LAND SURVEYORS NO. EAST DENNIS , MA SS. OF _z�> ' "-- /'