HomeMy WebLinkAbout0183 RALYN ROAD - Health 183 Ralyn Road
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LO CATION a,,S G E PE.RVIT NO.
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VILLAGE �,aL
I H S T A LLER'S NAME 0 ADDRESS _
0UILDER OR OWNER
DATE PERMIT ISSUED 4fl?
DATE C 0 M P L I A N C E ISSUED_
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No........ FR$..: .... ...
F THE COMMCMWEAO H OF MASSACHUSETTS
BOAR® F HEALTH
................._��v....... 0F........ .Lc�L!1 ......................
ApV trttttvn for Uii#x)5al Iturkn Tomitrurtion ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individu Sewage Disposal
System at: sz . .4,H---•••- ��t .�/ `•......0.2�,[---- ....................................... .. _7�1.'_.L -J
L cation Address Lot No.
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...___ �.(�._.. ._!.. -••---------•...............•----......_._..._ ........�.-- ...15.?CeL�.... � �W 1 ............
Address
W ................................ .
nstaller Address
Q T..;fve of Buildin�j- Size Lot_�.a_o_L ........Sq. fee
U Dwelling vNo. of Bedrooms___ _____________ --___Expansion Attic (� Garbage Grinder ,
Other—Type of Building ........ No. of persons.....;L ................. Showers Z — Cafeteria
p' Other fixtures .............................................
Design Flow..................... � __...__.___gallons per person per day. Total daily flow...........A-2d..................gallons.
WSeptic Tank i—Liquid capacity gallons Length......i......... Width---------------- Diameter---------------- Depth_--_-__--___.__.
x Disposal Trench—N . .................... Width___:.... .._.._._._ Total Length ........
Total leaching area--------------------sq. ft.
Seepage Pit No....... _-_--_-__ Diameter____��r.�_. Depth below inlet..... .......... Total leaching area.- 24elela._sq. ft.
Z Other Distribution box ( ) Dosing tank( )
Percolation Test Results Performed by...... l4 ................... Date----;2- d-::- -=----------
aTest Pit No. 1_.;-�-____minutes per inch Depth of Test Pit____________________ Depth to ground water_-___-.-_____-____-.-_..
Test Pit No. 2................minutes per inch Depth of Test Pit-_-_____--___-__-_-- Depth'to ground water........................
---------i xescript f SoilDi � ................ Y ......
0 � ------••-•-----•---------------------------------•---------------------•-•----------------------------------2---------------------�--�-
...--•••-------•-------------------
-
W ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
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'TT y g g p y of the State Sanitary Code—The undersigned further agrees not to lace the system in
operation until a Certificate of Compliance has b by t oard- f health.
Signed �' -
Date
Application Approved By..... 1 /J ------ --• _
Date
Application Disapproved for Ahe following re,sons:. ::__. '
----�y� �^
Date
eTmlt 0....... .......... SSlled.--- _ --..__.._..---•-------•lle
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No.._.............. Fps.....,.......................
THE COMMOKYVEAL:TH OF MASSACHUSETTS'
BOARD OF HEALTH
.................. .-1-..................OF.............................
Appfiration for Elhipolial Works Tontitrurtion rnmit
Application is hereby made for a Permit to Construct or Repair an Individual Sewa& Disposal
System at:
..............tzz.... .7..4.11
.....................
`...1.......... . .
..........
...... .....................
eatlAddre;s t No.
/1 4 j &S... 4...........mil .............q .............
Address
.......... ...
..............----------------- ..............................................................................................
installerAddress
Tye of Buildiliz Size Lot A-9-94--------Sq. fF5t
U
Dwelling No. of Bedrooms...e;.....................................Expansion Attic (V/) Garbage Grinder
P4 Other Type of Building ............................ No. of persons_,..-'"_........._...... Showers (*.2,) — Cafeteria
Pa Other fixtures -
7-------------------------------------------*........*-------I-------------------------------------------------*............1-111-11............
Design Flow....................Cl..............gallons per person per day. Total daily flow.......... .................gallons.
9 Septic Tank•L Liquid capacity/#W.gallons Length................`.-Width---------------- Diameter---------------- Depth.................
Disposal Trench—No. .................... Width Total Lengffl'........ •....... Total leaching area....................sq. f t.'
Seepage Pit No_______/----------- Diameter....�-v..f-------- Depth below inlet..... ......... Total leaching area-2./O.�.sq. ft.
Z Other Distribution box Dosing tank
Percolation Test Results Performed by-------
.................. Date......... d................
Test Pit No. I..., .2,....minutes per inch Depth of Test Pit.................... Depth to ground water-.-____---_-_-__---_.-_.
�14 Test Pit No. 2...........I......minutes per inch Depth of Test Pit----------------7... Depth to ground water........................
P1 ........7i--- ----------- ..................... -------------- ............ .......
0 4�-------------- . --.. 7
01......... .............. ..ya7ew; , I . .7 �./.;t
ipti ........... ...... .....
.—W
Descr* tipp of S ...... . ...
............. .......................................................................................................................................................................
U
------------------------------ -------------------------------------------------------------------------------------------.............................................................................
U Nature of Repairs or Alterations—Answer when applicable.___............................................................................................
...................................................................................................................................I......................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of'TTL- 5 of the State Sanitary Code.— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been-issn by tlie-board of health.
Signed .................................. ..........
In
..............-
Date
Application Approved
---------------------- ...
Date
Appliqa,tiqri.Disapproved for the following reasons:-------------......... ......................................................................................
...............................................i.................................... -----------.-.---------------------------------------
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
P ,BOARD OF HEALTH,
...........OF..........
. ......................
Tntifirati of Tompliana
THIS I of Repaired
1�4T CERTIF That pte ..,noL6dual.S�5age Disposal System constructed �rl�
b, .. . .. . ........
---------------- ...�77- - -----------------------------
t a 4�,,r;'
.. .............................
Ins
y....
at........ .......77"."',- .............
has been installed in accordance with the provisions of 5 of The State Sanitary Code as desqibej in the
0( ated
application for Disposal Works Construction Permit No. ... .....1--$?-a. ............. d,
.........................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WALL FUNCTION SATISFACTORY.
Inspector...... ..................
DATE......j. .....3.2.--FO..................................... ........
----------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF NEALTH
0, .........
...... ............ ..........OF.......... 4?, J4
No..........
4...... ... ......................... ..............................
Permission is hereby granted....... ..
to Construct 1'1/�or Repair Individ age ystern r _WI e w Dis al
a .... ................................. .
-VCt4 t-
-A o 7 Dated.._.__.`__-----....................
as shown on the application 10ri 9 1sposal Works Construction Perm t No.
............................
...... .... ..
Board of Het�
DATE.....e. ........................... ...........
FORM 1255, HOBBS & WARREN, INC., PUBLISHERS -
/ 003 �Zd- - V
L0CA ljN EWAG PERMIT NO.
J26
VILLAGE
I N S T A LLER'S NAME L ADDRESS
IL
- o a r R
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED _ 7,_ocd
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S/TE PL AN TYPICAL PROF/L E t
SCALE — /" = �` �� MOT TO SCALE
r c ��. 4 :_.So
/B„STD. L T. WGT. C.I. AIH COVER
22
� So
srx S O2' 52 ` /4 " w /30. 00` srk
'-` 4"C./. PIPE 4„BIT. FIBER P/PE T/GHT ✓DINTS
AUTLET LEVEL
FLOW L/NE TO
_
a OWL�L L IN /O" /4„ 3
.. ?
44 x 8 45 x 9 � C.l. TE£ C./. TEE = 3, y'
� Uwz
STANDARD PRECAST t4w
Qi a rc> f e L ,' . coo CONCRETE L�4GAL LON
i I ' ?C� ;�:ir7'." _S�'F'llc:: I,-/icrit. �..�2.i ---- ,
T- -- - 1 SEPTIC TANK
p =:� „ DISTR/BUT/ON BOX
B TO BE INSTALLED ON
/✓ LEVEL, STABLE BASE.
TIC TANK
2,00/e TO BE�NSTALL£D ON
LEVEL , STABLE BASE
�t 2 — I/B TO 1/2 WASHED PEA STONE LEACHING PI
W Uh/ELLlrt/G ALL AROUND FREE OF IRONS FINES BASE TO BE LEVEL
0 7- .G C' AND DUST /N PLACE
BRICK 8 MORTAR COURES
� 30` 3/4' TO l-//2 WASHED CRUSHED
44 A +, AS REOU/RED TO BRING STONE ALL AROUND FREE OF
_ " f COVER TO GRADE. 24"C.I. MH COVER IRONS, FINES AND DUST /N PLACE.
4l1 - , c7 J i AND FRAME
o
f N4L"
_�.a. -i r.�-�,.•.- LEACHING P/T SEC T/ON
B' FLOW L/NEq�. --
1. CONCRETE TO BE 4000 PSI 28 DAYS
PIIAF
_.
; '
i �\ --T�„ 2. REINFORCED WITH 6" x 6" N0.6 GA. W.W.M.
--L 3. 2' AND 4' SECTIONS ARE AVAILABLE FOR GREATER
DEPTH REQUIREMENTS.
OPEANNG W/TH 4-//8" 4. NUMBER OF PITS REQUIRED 4LVIF
QIJTER DIAMETER 8
p ' NOTE: EXCAVATE TO ELEVATION OR LOWER AS
1-3/4 INSIDE bmmr ER „
5 REQUIRED TO REMOVE ALL LOAM AND CLAY BENEATH
PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN
GRAVEL TO DESIGNED GRADE .
o'
ti
6'-6•'
Sz2 , TO, 4,_0„ '
019 MIN.
(NOT TO EXCE£DC3/VT/MES EFFECTIVE DEPTHI
06 •
3 ,8p. .*_.4_.l WATER TABLE
CIO
QQ 3cx��
SOIL AND PERC. DATA GENERAL /VOTES
PERC. RATE MIN. /IN . NO HEAVY EQUIPMENT TO RUN OVER SYSTEM.
¢� \ SEPTIC TANK, DISTRIBUTION BOX , LEACHING PITS TO BE STANDARD
1�VM .Ut w.a�ryick � .4.�Svc .
TEST I�Y: PRECAST REINFORCED CONCRETE UNITS.
l ' l WITNESSED BY: lr4411- /t> ,CRA} " BBN ALL SYSTEM COMPONENTS SHALL BE INSTALLED HV ACCORDANCE
TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE ,
TEST PIT GR. EL.: 4IE DATE-- •=1 20%D MINIMUM REQUIREMENTS FOR THE SUBSUFACE DISPOSAL OF
TEST PIT NO. ��TEST PIT NO. SANITARY SEWAGE EFFECTIVE I JULY 1977.
O 0 ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE
io -
` a BOARD OF HEALTH.
AT COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE
,,rA 4J BOARD Of HEALTH SHALL BE NOTIFIED FOR INSPECTION.
'„O 07.�.� � r .. /Y/4a '.4�/C7 PITCH ALL SEWER LINES 1/4" /FT. UNLESS INDICATED
OTHERWISE.
PO itf 1J /44" iVO 4Fsa,0Vt7. W A7-1
W477 ,e E4 . 14. 0 DESIGN DATA
BEDROOMS 3 DISPOSAL Na ✓ f REV E3/¢ 8p ,E"firy
EST. TOTAL DAILY EFF. 3 �Q GALS.
L EGEND — SEPTIC TANK GAL.
SIDEWALL AREA 2.6 GAL./SQ. FT +A//� �/ 'j'
` BOTTOM AREA 1-0 GAL./SQ. FT. SEI�YAGE DISPOSAL S/ S/ EM
Ox00 EXISTING GRADE LEACHING REQUIRED /d3-B9 SQ.FT.
ZONE 2�, c?Cry L oo FINISHED GRADE ACTUAL LEACHING AREA 3W7. 49 SQ.FT. / FOR
T- 0 . 0 INVERT ELEVATION
DOMESTIC WATER SOURCE :
- - PROPERTY LINE
PLAN REFERENCE 1_c' %-
/J C c� ;:.'f ;•- L;.caG�,y�"�_'y ,���'�'= ''�.-.5 }L�r � �.�r�✓ �'• :'e T �A.�'i��'T�4 /i-9'•4.�5
MEAN HIGH WATER // ,r, ,1 SCALE' AS INDICATED DATE : 2f
BENCH MARK DATUM -L -k- --iL MARSH , J �� f� '1 9 WM. M. W4RW/CK B ASSOCIATES
t BOX BO/ - NORTH FALMOUTH
MASSACHUSE T TS 02556
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