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HomeMy WebLinkAbout0003 SANTUIT ROAD - Health SanA-u�-+ 3 Scala C T ION SEWAGE PERMIT NO. LAGE I N S T A LLER'S NAME ADDRESS BUILDER OR OWNER DATE PERMIT 'ISSUED DATE COMPLIANCE ISSUED I }3 'Sf F 3" C s-a i ►' D 390 F - 77 ' F TDwN Ha O THE COMMONWEALTH OF MASSACHUS.E-rTS BOARD OF H ALTH 3 C. '. ..'.`� ... ..........0 F.............0.�. .`�- �--...------------ ........................ �� ��� .2� lirttti�an for Disp' voal Marko Tonstrudinn ramit Application is hereby made for'a Permit to-Construct (X). or Repair ( ) an Individual Sewage Disposal System at: i 1 Zocation•Address or Lot No. ......... _. ... ... r, ® ..................... .......... ............... •-•--- •...------•........._.....................:.__ t Owner -Address w1 ---.....................•----•-----•--•_........::_:_.._............._.....----•.......•••-_._.. .......••-•••-••-•-•-•...•---.._...•-•••-•••_...................._.._.......... _............. M Installer Address t " U Type of Building " .,Size Lot.2:o`C�Op_ Sq. feet Dwelling—No. of Bedrooms.........................................Expansion Attic ( ) Garbage.Grinder ( ) p, Other—Type of Building..........:.................. No. of persons............................ Showers ( ) - Cafeteria ( ) P4Other-fixtures .----•-----------------••'--•-----......_....................._ ......----•--•--•-•-•-• .--••••-• ...................................... W Design Flow.............�eJ.__.__......:.:......._galloni per person�g� c�ay. Total d�fy�fiow.._.___�.�J..o..._.____._____...... to WSeptic Tank—Liquid capacity��oo gallons Length......_.2.:.. Width_ .... Diameteri.�...... Depth. x DisposaI Trench—No. .....................Widti}_._... ._._.___._ Total Length........i:.._ Total leaching area--- _...:.........sq..ft. 3 Seepage Pit No........r............ Diameter.-`�_--..e ...: Depth below inlet.. ..e ::Total leaching area.�Z� S.sq_fT._ GI D z Other Distribution box ( ) Dosin to t-a�r16, " ' e.. r 1�25 83 Percolation Test Result Performed'�by.......:............:....................�.P:._..*..........___. Date--__--- -._........-----.-_--......... ,aa Test Pit No. 1._�2`...minutes per inch Depth of Test Pit...Xz-...:_. Depth to ground water... ��� ��� Gz, Test Pit No. 2...::.........I...minutes per inch Depth'.of,Test Pit................... Depth to ground water......................... .................................•._.__...... ac e .........................................................................__....... O Description of Soil.....:.:........................................... :...... ....... ••S.............. .--_••-. ` P` ..............� x .. .......... W ^------.••••-••--••••••--•--- •••--••---•-••-•-•--..._•--•--•---...•-•-- ... .. , ._...•. ..........................................•• •• ............ UNature of Repairs or Alterations—Answer when a�P cabled �z�Xll._ `:�_._....1_`1:�..............�... .._..... .................:.....•--•-••-••--••........-•-•-•--------•--...---•••••-•............_.•.._....L .-- -------------•--------- --------• •-•--...------.................... Agreement V , The, undersigned agrees ,to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 4ITLZ .5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been sue by the b and o health. Signed..... .......... ... . •-......••-....... N Date Application'•Approved By.... -emu �- Date Application Disapproved for the.f ollowing reasons.................................................................................................................. .. ...................................° Date............. Permit No.... � Issued_ --_.._............................... :,- •Date j1 t No ................ FRz........................... THE COMMONWEALTH OF MASSACHUSETTS- BOARD OF HEALTH ..................... ...... ............OF..... ...................... a carp; bT3 Appliratiou for Mnvviial Works Tonstruaion r0mit Application is hereby made for a Permit to Construct O or Repair an Individual Sewage Disposal System at: .... ....... U*c*a_t io"n....A"dd­r*e's-_s.............*------- -----------I------------I----------------------------------------------------- ----—--- .......................................... ..........................................or-... ............................... ....... ....... Owner Lot No. Address ............................................................................................... ................................................................................................... Installer Address t Zo c�—Type of Building Size Lot........_..,............ ..Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder Other—Type of Building............................. No. of persons............................ Showers Cafeteria Other fixtures .........................................................................i........................... < .......*,*-**'*......... Design Flow............155.......................gallons per perso�gg day. Total �4ily,flow................................... .....galloas, Septic Tank—Liquid capacity ...... =-1-I N!�O,Z�.gallons Length....... Wi(rk At�... Diameter__�'�...... D e'p*'t'h:!! Disposal Trench—No..................... Width.....p.=t......... Total Length.............. Total leaching area... sq- ft. Seepage Pit No........A........... D'iameter.54.e-'6-. Depth below area.�M q-f t- ...... Total leaching Z Other Distribution box Dosing tank %k r�,,\Y- , 1P Percolation Test Results :Performed by.... ......................... ..................... Date..... ....__.......................... Test Pit No. L. ..,minutes per inch Depth of Test Pit... Depth to ground water.. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water._.................._... .................................... 0 .........I............*...................... --­-----------*......... Description of Soil..................................................................................P 0141) -----------------------7--------------------------------------------------- .............................................................w........................................................................................................................................... ................................................................................................................ . ........ .......................................... e....... ------------------------****....................................0 Nature of Repairs or ions—Answer when applicabl .............................. .............................................................................................. ........................................................................................................ Agreement: The. undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIILZ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operatioh witil a Certificate of Compliance has been 'ssue, by the.b and of, health D .......... Signed...................... .... . ....... Date ApplicationApproved By......... ....................................................... .......... Dal'e Application Disapproved for the following reasons:.......................pp . .... ................................................................................... ........................7................................................... ---------------------------*------------------------ -------*--------------.............. Date ram \'`­-'Fermit No...........C.41. .........C........................ Issued.. - .............. Date ........... ------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........................... ........ ....................................................................................... Tatif irate of Tautpliatta THIS IS TO CEBTIFY, That the Individuid Sewage Disposal S;h's teip,constructed ()e) or Repaired by................................... .D..H.n.........G..A...V.1.N...............................................................t .................................................. 4f Installer at... ....................................................... _Z�Ek ------------­*.... ........................................................................... has been installed in accordance with the provisions of T I T LE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.... ..... dated........ ..................... .. .... . .. ..... .. ---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE, SYSTEM WILL FUNCTION SATISFACTORY:; DATE...... . . ............... Inspector....... .......... . ......... .............. 0­6.....*WON,&" a.d.a.-............ t. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF...... ....... ........ ................................... .. .✓.............4 1 . !�7 No......................... Fn.... Disposal Works Tonstrurtion frrmit Permissionis hereby granted.............................................................................................................................................. to Construct or Repair ( ()-an ,Individual Sewage Dispqs S em at No.....), -�-( 1-( _, I UT 2- C�............ ..................................................... ................................................ .............................................Z.............. Street as shown on the application for Disposal Works Construction Permit Nol�- _$.'��5 Dated.... ............... ......... ............................ Board of Health DATV-... .................................. ' 7- • L: SECTION ."SEWAGE .. .. . _ T- I I —SEPTIC TANK — Z „p„BOX,— . Z. ._ -LEACH_ TOP OF FDN L-OT 43 -_----�O(MSL)# ..Z..OF I'STO 4z" WASHED STONE �� 0 `�J ly I IN• OUT• IN• IIV• O /o Y� o �Q —.... OUT• ! fi3 a—G �q ELEV. 5Z..26 IE K .OI ELEV. ELEV. ELEV. Cs S a { ° j• `1, �- ELEV. ELEV. _�/! Lp 011\ t WASHED STONE i 9 .`.\ �� ti 4.6 T p4a TEST HOLE LOG p- dam. _ a55.29 $"�`` i TEST BY •Tf�1Qf?�A1I ,,!ACOg1 I1iZS �3 WITNESS ' TEST DATE DESIGN ✓ BEDROOM HOUSE r / ♦ Bi i T.H. # 1 T.H. ELEV- SSZ� ELEV. IZ't 0 54• _9 PERC RATE L Z MI DISPOSER DISPOSER (8' FLOW RATE 11O (GAL./DAYS! , �O xU — ,— i SEPTIC TANK LC N REQ'D SEPTIC.TANK SIZE 1000 S/ _ -`"' C TO LEACH FACILITY — SIDE WALL 0L,(D._ '1.�..�- (2,5) _ JI1 ,0 G/D. 000 BOTTOM 8�-�ZL= •�,i l l:Q 1 = �p.�� G/D. _L_0-r A-Z TOTAL ZOI. i = 2� �, LOT 4/ _ 7-01c)(gosc USE: owe LEACHING PIT - - WATER ENCOUNTERED ' �E"jI� ( � � � N e t�` 1�1?�a�1•yC'� 15t� T° � NOTES: (UNLESS OTHERWISE NOTED) r SO 1. DATUM(rASL,+ TAKEN F CX7_OLT_----------------GUAt�F2ANGLE MAP 2.MUNICIPAL WATER____ -- L ..------------------AVAILABLE tk1`�i' 3.PIPE PITCH:Va"PER FOOT ,V' ✓I 4.DESIGN LOADING FOR ALL PRE-CAST UNITS:AASHO -44 : ARNr;K, G IJ 5.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT. 04ALA �.. 0----DISTANCE AS CERTIFIED - 6.PIPE JOINTS SHALL BE.MADE WATER TIGHT 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. - CIVIL �+ STATE ENVIRONMENTALCODE-TITLE5 No 30792 *� ' !- P - � s ARNE �ya LOCUS: L07T-`- OLD'OY T R ROAD �NA b H. aru�r�A. OJALA K//1/GS GRANT C REG.PROFESSIONAL-ENGINEER -7 ,. I ; . •...._.. �S ��CR O o REF: _BK,.2/�� P^.SEA. d©wo cape engineerin4 S CA/?I- BERGFOR PREPARED FOR: CIVIL ENGINEERS 6Y " LL E/VL N RNSTA,BLE MA. A ,BA BOARD OF HEALTH LAND SURVEYORS REG.LAND SURVEYOR , _ CONTOURS (EXISTING)------------- (PROPOSED)—O—O—O—O— APPROVED /'t� , DATE 1`ISTA�7I-•�. MA � Yarmouth&Orleans,MA SCALE. 30 2-5 D TE r(:53-/95