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HomeMy WebLinkAbout0679 POPONESSETT ROAD - Health �� cdness�- Cv / - -- 671 LOCATION SEWAGE PERMIT NO. VILLAGE --� INSTALLER'S _ NAME i ADDRESS ja4 n 1 , IFO It �lf 4A�0-440 e U I L 0 E R OR OWNER jp>V4 le ,�A{�ii9�J, i��sl • DA T E PERMIT ISSUED DATE COMPLIANCE ISSUED r � ���� �� J n, ��oNT ._ ;, �. , � 6 ' � � �" � � � � � � , �\'� e , -, �` �� b G __ � .. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ......... d�l.�O'.............OF......... ,�c T ................----- Appliration for Uiipnia1 ?forks Tnnitrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: P-0,b A/,- i��7"U..T � �QT 2G ............ ......... ........•- ..... •-- ...... •-- ... ......... - J ocation-Address or Lot No. �d. .l��1•- .C�--•-•............... ---•--.....--••- ................ - Own .............................................................Address Installer Address Type of Build Size Lot..... 7� Sq. feet Dwelling—No. of Bedrooms.......................................Expansion Attic ( ) Garbage Grinder (><) 14 Other—Type T e of Building ............... No. of ersons.....__......__......._..... Showers — Cafeteria a YP g --------•---- P ( ) ( ) a' Other fixtures .:................................ Q ;52F:V;VIOiX------------------- -------------------------------------------------------------------- W Design Flow....... /Q..............�,v_gallons per persaft perday. Total daily flow............. ._...:............gallon. WSeptic Tank—Liquid capacityl-___.._._gallons Length................ Width..9&_... Diameter................ Depth.. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......2_.......... Diameter....1/ff......... Depth below inlet............... Total leaching area.S3 ....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by.......z✓a. ........ Vic........ Date.... /3{ /------------ Test Pit No. 1. .2...minutes per inch Depth of Test Pit....l_¢¢��_ Depth to ground water..:............... Test Pit No. 2__C__.G2._....minutes per inch Depth of Test Pit... Depth to ground water..................... a --•-----•---------------------------------••-••---•-•-••--•-•••-••--•••---•-••-----------------------•---------------.-----------•••----•----------- •-- O Description of Soil...�Z•- -••••Q --24..-•-Td,-_�., Yo,—%F•� =*2 - D �-2¢ �'dP F_,4a-S50iL UNature 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 TA!T1,; 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........... ....... . ................... ......�'� .............. ��� D to Application Approved By• ••• :-- ... f� �............ Date Application Disapproved for the following reasons--------------------------------------------------------------------------------•-••-------• •---••--.....•----- ® .................. -----------------------•-•-••------ Date PermitNo......................................................... Issued....................................................... Date F�s... ........................ a, THE COMMONWEALTH OF MASSACHUSETTS # 7 BOARD OF HEALTH _._O ... .....OF.........131416—Al 5%/91� i=.................•.-. ----------------------------- Applirtttion for Bi_qpusttl Works Tomitrur#ion ramit Application is hereby made for a Perm�it to Construct or Repair an Individual Sewage Disposal 'System at: .........._ _... =J� --.:jr✓ i--- -- l-------� ................... .......•-- o T --G_.-.�. ..........-------•------------........... cation- dress or Lot No. . v4 .. ....... Q c�S :............ ................................................ ------•---•-................................._ E. .... Q.... Owner �. Address •; --•-••---•--------••------.................•.---................................................_.. 1 Installer Address f Type of Building Size Lot....�7 D �� �Sq. feet ............. V Dwelling—No. of Bedrooms...:........................................Expansion Attic ( ) Garbage Grinder Other—Type of Building ............................ No. of persons............................ Showers — Cafeteria Other fixtures -----•-•••--..................... W Design Flow.........1f 4.........................gallons per per-serr-per day. Total daily flow.............. .. .(.....................gallons. 1:4 Septic Tank—Liquid'capacity:lr':o gallons Length_':.,� '.._... Width-__ _. Diameter__._____-__-_- Depth....S ..... Width.................... Total Length Total leaching area.._......--.........s ft. x Disposal Trench—No. .............. g g q. Seepage Pit No......%'...._.__.. Diameter..... ..... Depth below inlet.......1_0�........Total leaching area..:'_-' ,...sq. ft. Other Distribution box ( ) Dosing tank ( ) ,� )--I Percolation Test Results Performed by........ ?._/:�% is>='���_.....':' C......_. Date_..!;<.__3Z/r ........... as Test Pit No. I...`L.. ..minutes per inch Depth of Test Pit...... Depth to ground water.....--' ............... Test Pit No. 2...�5_: ...minutes per inch Depth of Test Pit___-3 ....... Depth to ground water-----............... ---•----------------------------------------------•--•-- ...............................-•-••-•----.........•-••-----•...--•----•-----•-------•-•-•---.--••- O Description of Soil s - li ._ v Tv,.� , >'�,� o,r �2 .- - o_� !',�_.. rcf�3SoiL ------ W ••-----•-•-----------•-••--•---------------•----........................-•S'.i7�c/%--•--••---•--•----•-----•--._......--••--................................•....Si..iL/�------------ UNature 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 TITIa 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss ed by the oatof alth r� Signed.............. ...................................••----•---------•-••---••-..._. ................................ D�Application Approved BY__ ._ ^_._ .............. �/ ,� ............ -•--- Date Application Disapproved for the following reasons:------•-------------------------------------------------------•-------------•--•----------------------------••-- ....••----------------------•------•-•----•---•-•----••--••-•.....•••-•••---•------..._...----------------•-•-••-••••-••----••-•----••-••--------------•--•-•--•-•-=-' ......... Date Permit No..............•-•-------•-----•----•-----•-... Issued Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......l�s°G;.t^~`............OF....... ................................... Tri~tif irtt�e of Tnnt�rlittnrr THIS IS TO CE IFY ThatAtInd,*vidual Sewage Disposal System constructed or Repaired ( ) --•-----•-•-------- bY.......................... ..... . , } Installer at......... --' - ! _ " '-------- -----------------------•--•-•---------- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No-----0f' .......... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISF CT RY. DATE... -------------•--•--••-----••-- 1. J 2( ........ Inspector.._.. ----•------- I ---�-------•-------•--- ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT /....lJ. . .... ............OF..... .... _. �r No..e�-� e' FEE.... .............. nrn Atrinrn anti Permission is hereby granted............ .... ••• • ---_. . i--------------------------------------•-----•---.---•---•--.------•---•--.-- to Construct or Repair ) an vidua _ e �ageDis�,p�osal Syst at No ... -- ------------ ------••--••-------•-------------------............ --_.. .--- ••• _.. Street as shown on the application for Disposal Works Construction Per Dated .._ ------------------------ ••............ -- ---------••-•....... ......... Board of alth DATE................................................................................ FORM 1255 HOBBS & WARREN, INC., PUBLISHERS 11 �' t t }e,-., r• ' 1. F: rc y�"�� ,f ti 3�,�p ..- ;� , �� k. ' .. yp. t a LOT � 716 Ir tT � , . µ J t1l� �+to2 .i s _ .d r dt . i; n- a. ..4; J , 1. riri. .i! 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'i. - 4 - ..- ]. _.-.. .. .... ......... . ,, .. .1%' 1. a.. d w� t-a .._ :.. .,.,h. -._.k-. 3 C _ _ . ,.. ..:.,... .._,-:.. .: .. , may- ... .. .v .,v. ,. ._. .. .. `.. ... ... .. :.-- _ -- - _. , ,.. .'. .... . ... t : s.. .rn« .. ..,. ..mot:. .� _ ,�... C �WORKMANSH ER G , -.... . -. .-0 BUILDING «., °, /at D PFT ��`ALL t DATE .OF SOIL TEST ,. „q . o SHALL; CONFORM TO' WITNESSE .tea .PG . +` v._ ' INLET SEPTIC =TANK .. "= o i FT . . v,. . ., is 5 AND.. THE . TOWN OF liL .. .;, _ x o_ T _ SEPTIC.. TANK . .,.,�: -OUT: ET �. . .. .., RATE M hN./1 N C.H .. a �, - __ :.. R"`:S;U B S U R FA'Cf PERCOLATION: f . , .h,. . , .,,.... : ,> _. ._ -,:;:_,. .. .. .f: . /v ,. _: ,, ., AN;D:: _RE,GUtATCONS-_ ` �, _ �: :. ,,. .,.. _ .., I+�L.ET..QISTRI6UTIQN BOX, - FT.a:... a.,, .—..j F•t. f :,`. �:. E _. . ,,- :,;. . . x,. __. . - _ -.:�.., , 01SP.0:SAL� " OF SANITARY: . S AGE.:; _ HOLE., t -; 08SE.RVATIN .HOL 2. t .. .-..., : . _O.SSERVATION. . W. :..., f. 'x' d . LEVATION AT.ON .raFT ' i J FT —.o S .. , : ::..,�e •.�,� ; .,-, CAI T 93 FT.BOTTOM �LE CH�NG=i P,I > _ T - DESIGN CALCULATIONS F. m NUMBER OF -BEDROOMS;`: . - v yam_. GARBAGE:.`'DISP�OSAL'. .U`Nf.T.::. Xq ; TOTAL ESTIMATED -.f LOW (/ia :GAL'./• ./DAYS 'BR ), GAL/DAY` Sq•moo ; . C a CAPACITY. _ d . GAL .:..,. , . . .:.. _,. _REQUIRED - SEPTI TANK Spa. SEPTIC E -INSTALLED .: . GAL. - B LN 4. ACTUAL r SiZE OF TANK TO STA ACHING AREA REQUIREMENTS _ w A F LEACHING EA WALL ARE s GAL./S. .: BOTTOM ARE. A S. - .+ Cl B TT_ f-S DE AL LEACHING C OM i /ate" 5 GAL } . RESERVE -LEACH{NG r C,4PACITY. : / GAL. TOP OF FOUND. E LEV.=/090 /4 ' CONCRETE Ott SCH. 40 CLEAN 'SAND ' 0 R,1 PVC PIPE CONCRETE m MINI .P1'TCH COVER -: p CO t'r �T H Of I/8 PER. :FT: EP M�, 'o cP�t qSf Sj.. I2tt MAX. RICHARD.� �yG 2 %.MIN PITCH 3 t JAMES u i tr �` Jf4ME5 ='C cat O'11EARN ' - N z , 2 LAYER O F 1/8 1>/2 O`HEAP14 No. 27871 _4 FLOW ,LINE. 9F ,o ,.; � WASHED: STONE= o € rs Ott CAST IRON. z 9 - ut. - WASHED STONE #1 y P,IP€- MIN. ' PITCH _ 1 3 _ 1/4 PER �FT. _ �-; - _-. . ,_ �..4�D�ST: � ' t•-` a P" o -� �f'REGAST G - �._ �BOX � "�` r - 8 r - , I• f .y / •_h MASS SEPTIC �.... � •- tll � H E AR iV f N C: R'l.S _ TAN K - k t' I348 ROUTE I'3'4 ._.. �.. , , . .. . .- .. � . ... . . . .�.., _ -..._ . .>... � - EAST QENfvI._ MASS PROFI LE Of..-;-: � GROUND. WATER r...TAB�LE JOB N0. C.LiENT _ . .. GE D S - x , x - t. _ I-t.E 9�9 DATE / ET 0 ;.