HomeMy WebLinkAbout1287 OLD POST ROAD (CT & MM) - Health r -�09 6
LOCATION SEWAGE PERMIT NO.
VILLAGE
c o -ro-l-r
INSTA LLER'S NAME i ADDRESS
Jam,
/-.5 /apse
e U I L D E R OR OWNER
DATE PE MIT ISSUED 7— 72
DATE COMPLIANCE ISSUED
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No..- --- ...... - Fps.. Q............
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THE COMMONWEALTH OF N)vASSACHUSETTS
t7, 1 BOARD OF HEALTH
TO.r+s/ ......... ......oF....... (Z1. rW
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Appliratiou for Di-qVviia1 arks TiluBtrurtion ranfit
Application is hereby made for a Permit to Construct or Repair ( } an Individual Sewage Disposal
System at
LOT 11 OLD PocT 90A.,o
................__.............................................................................. ...-----•-•-•-••---••••--•-•-•---.....-----•-•-------.........-------------•-------------....--•--
anon.Address ✓ or Lot No.
. �_.p .. L_ ---------------------•-
c.G.4�L4�1_........ f R.1!✓..f l:._... )',Al✓N.Al ,.M I---••-------------- ---- ---------
` ` �j 1 e ss
rie � `l�'.. .�Y �
Installer Address U Type of Building Size Lot__.46S.'t_"�¢__-..Sq. feet
Dwelling—No. of Bedrooms.................. ......_..._...___.___Expansion Attic ( ) Garbage Grinder ( �-}-
'4 Qther—Type of Building No. of persons............................ Showers —'Cafeteria
a Other fixtures --------------------•---•-----•.
W Design Flow.........................:... ....................gallons per person per day. Total daily flow_.__..._.. . ..
............
WSeptic Tank—Liquid capacityl5Q..gallons Length-_� -_0"_ Width._CL_010. Diameter-_-___.__..._- Depth.CQ'-O".
x Disposal Trench—No..._....`...._...._.. Width................... Total Length..................... Total leaching area----------------
Seepage Pit No......I______________ Diameter.._... Depth below i let...'7'-2"_.._ Total leaching areal �P's F �9AS
Z Other Distribution box ( � Dosing tank ( ) ��' G� 7---2— Z/ o�',• ERT y
a Percolation Test Results Performed by---- Date... ..L,?_..y g(`7E; rl
a Test Pit No. 14---P-------minutes per inch Depth of Test Pit_____,¢4. __-- Depth to ground water LRy
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground waterl No. 19875
p�' •------------------------ ''� �.b'
IT e q of
Descraption of Soil r� L -L t' °
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 L1TL:,
p 5 of the State Sanitary Code—The undersigned u41th.
es not to place the system in
operation until a Certificate of Compliance has b' issued by the bo •d 1 Sig ---•- •. . -•-------- •-•--•----
1,�� _ Dat
Application Approved By--••- •r. --- ----L%• `�' F .................... ---
Date
Application Disapproved for the following reasons----------------------------------------------------------------------------------------------- ............... .
.........-•---•--•---•---...-•-•--•-•-----...---•---------------------------------------------------------•----•--•••-•--•-••-•-•-------- =------------------------------------
Date
Permit No. ss ed.. .1 `-�
l• — /Date
O t ti.
• a
7) �/3� L ................3 }
No. •- ..............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
. lt ra to
u for Btipn,sal C ti r r tan. per tg
Application is hereby made for a Permit to"Construct (° "or Repair ( ) an Individual Sewage Disposal
,System at
. L __________-... = _.......
e.. -ocation Address orLotNo. -
"
y; ............ ._.:__.»----------------------••----.......-•--•---••---•-•--•-•................ ------------...... ..._.. ---•--••......--•----•--•-.............._...--•---....
W a �
Owner Address.
---- ............................•-•---------•------•-•----•--•------ -----
Installer AddressPQ
_
Q Type of Building Size Lot_ 0._W __Sq. feet
Dwelling=No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder
Other—Type of Building ___________________________ No. of persons.............................. Showers ( ) — Cafeteria ( )
a' Other fixtures __ ------...........................................................................
Q
W Design Flow..................-5r3___.__ ____gallons per person per day. Total daily flow________4 s .....................gallons.
WSeptic Tank—Liquid capacityt500._gallons Length__f1_mCs__:"Width__ °:jb.j'__ Diameter................ Depth:6.'- 1°
x Disposal.Trench No. __ .... Width____.................... Total Length _____________ Total leaching area....................sq. ft.
Seepage Pit No I_- ______ Diameter p g A. t._. Depth below inlet _____. Total leaching area ....s
Z . Other Distribution box .( Dosing tank 7 0F M
Percolation Test Results. Performed b -_.__ „'s" _ ;_ _ a!'�.__?C_: _. Date_._ u_ ° gssq��
y ' . �i � . p�-• BERT
Test Pit No. 14... minutes per inch. Depth of Test Pit 1�- ______ Depth to ground water, L"" . —rA001V
fs, Test Pit No. 2 _____________minutes per inch Depth of Test Pit.................... Depth to ground water...... I_c3 _._._.RAYMOND
, . ....................... �F� _ �escrptonooi ...Ln.�.. r "
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'TT
LE 5 of the State Sanitary Code— The undersigned furtl era reel not to place the system in
operation until a Certificate of Compliance has be& issued by the bo -d I �lthQ
Sig
.�......
Date
Application Approved By / •-•-•------------------ -7--{ ate D
• Application Disapproved for the following reasons------------------------------------------------------------------- ------= ------------ - ate----•,•-----
---------•-=-•--••••--•-•-••-----•-----•----•-•-•---------•-•-------•-•---••--•--------------•---------•--------------•-----•-•---••------------------------------------------------------------•----
Date
PermitNo......................................................... Issued......--------•-------...............----------•-•---
Date
w' THE COMMONWEALTH OF MASSACHUSETTS
BOARD 'OF HEALTH .
f
+ #` ..........:............O F...... s ►. .._........................... ,
5°y Trrtgfiratr of Tomphattrp
T ' S S TO CER FY��hate Inu dual Sewage Disposal System constructed ( ) or Repaired ( )
-:..•-----------
/�
at 11 L fc.In-al� --E��r , �� > .
has been installed in acco11 rdance with the provisions of TI�L 5 of The State Sanitary Code as described in the
application.for Disposal Works Construction Permit No-_-((��?---•• Z ..... S_.S_ ..... dated. .7-.-_-/-_..7�j�____________________
TF9,t ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE Inspector .
THE COMMONWEALTH"OF,MASSACHUSETTS
BOARD `OF HEALTH
0-7f
.OF CA) 1 -
No. FEE.... ..............
Uhip" Vfx,
ork� T" h� toff rr it .
Permission is hereby granted..... - •• -�; K�5 - �••-•••• ..........................................
to Construe ( ) or Re air'(/ ) an In vi�i- 1 Sewage DispJo, ystem
at No.'•• .��ll�------ - ! , . .�_...... "l f
Street
as shown on the application for Disposal Works Construction Permit)Nol ated
u//d
DATE---- "<'� _1 .7••• • a
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS - -
Lc-)T S i-t v�;.� v•J 1'�.e , 7 ,.� �. r l�.E� : PL- ,U u iF o I i•�)
Fop Cat_r kn�� �. �..« l010,3ca" Gla.-e lac p/IA.y 7) t 973
y Crrca,r'f. s ems, , 10f, P,C HYA-AJaIS
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_ TYPIGA•L- 5EPTIG -rA`tvW- TyPl CAL- C>(ST-C(8UT I OKA F3O?L
1 NOT TO 5CAL E 1,40T Td 5GAL-E
ESL
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Wit- r� I
a• / : / = \\ 43 f``„Va TOP OF �00tJv.
777
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h `` �hq +� t ty� P�/G -_ aR - ... -- T
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-A i.',.,,�^.'c' Rt �C' �4�' }k ./j Q 0 o, °.o. 4 __._�o .•� D'. ."a -•. V, �L.E)Q �GL- - i L./ GO �
V
J ' O
J�PT"IG T�tJ T� SE LEVEL , V `-'
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Indicates Test Hole Location "�A - _ tom'--0
ie Indicates Perc. Hole No. 1 SY TEM P tt�
(V I NOT TO sCAAL.E
w
`� � 4 � Indicates PErc . Hole No. 2 LEA.CNrU� �
; 9
50c Indicates Existing Contour
Indicates Proposed Contour
j� Indicates Existing Spot Grade
�1! i
3 .52X9 Indicates Proposed Spot Grade
Indicates Proposed Leaching Trench
t GENERAL NOTES
1. 15oo Gal reinforced concrete septic tank a-nd concrete
distribution box by American Precast Concrete, or equal .
2. L� A�?►a�t� ► Board of Health must bE, notified when system
is nearly complete and prior to backfilling .
DESIGN CRITERIA
ToP o'r CC7 ,+ ---- 3. Elevations based on -ti�1•�t3.��z:_s� Datum Plane.
p. �;C No. of Bedrooms 4 . Unless otherwise noted all system components shall be
No. of People/Bedroom = 2 installed in accordance with Section S of the State
Sanitary Code dated Play 20 , 1977 and any local rules
Gal/per/Day = S5
applicable.
- .wy� _..___..._.._ _ _ T ,. G 3. Any deleterious material must be excaratEd and removed
eleteri
� .� Garb&ge Grinder = y,r_, ( lira x �1E• PA,1 Y �� w to 3" below the surface of the natural permeable soil .
Total Daily Flow = Backfill as required with a gravel or sand fill material,
�,_ , �_. _. „ having a percolation rate in its original location of 2
2 People/Bedroom x BR x Gal/Day/Per.son = _. ._ Gal/Day �; I'�Gr '' (t?r~. , '.� 1 >'-Ct� i
�fLl � = min. per inch or better, and free from fines , clay,
organic material, and large boulders
r e
Bca`t otldl P o .`'ref 3 = I I3, 1 X 1,0 GAL/tS
�r �Ei/aL L- ,fit LA, T��s ) � Z73.3b x 2.�
-
- _ �_. a• 7 ` GrP13 �Vtj14' f- ►:
�
SCALE DATE- SHEET �
BRADFORD SAIVETZ & ASSOCIATES. INC.
REV DATEREVISION MADE CHKD APPD :'� `l , � f ENGINEERS AND ARCHITECTS
NO BY BY BY ; ' ( / +" s + DRAWN BY: CN1i B� APPD By PLAN htQ
��� � _�� iRAtNTR[tt MAKE 02184 t6171 648-0620