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HomeMy WebLinkAbout0079 WINDSHORE DRIVE - Health a mshibre. b'e , s r J M I ZBA - 04-13-16 weal© www.myuniversalop.com phone:1-866 756-4676 U NV9 21 1 MADE IN USA p L:r l�:►mil T�/�_1_A: a • ' StUrrt_'E �cuntL�! - � �»_�r�c�� � I 1� • I uo GA2rnG� �r�I�1� .. r v�. � � t t 3,•Z`�`� 2adl Lam( FLOW SEF3riG T/�IJK. = 330,. ISO % • d.�S 6.PD. � USA- 100C-3 6A.L. WGWALt_ Atzl:...A _ tso s•t=. IC�to SF Ic 2.S + 3 7S G.P.D. A2�A< <O ST. 6eK P�xo P. O 50 Sim'. i .o. Z 5b S.P.P. PIT TnpR y c l �6. TOTAL 'VSS16M 425 G.P.D. ' I,M io• 0 1 'rbTnL 'C�As.tt_�( FLow= 3306.PD. i' . , _ ; • •� ' •'i' '" � 11 ' 1A • = 1 t 4 ; MlIG ►DL&T%oLJ O&TE : uJ 2Miw' oo LP-56. ."p/ z`a SIK P I r x'�' �Rk•iprl. e ` c { i t _ 1 .c F: �.-' 114 Of RICHARD b AL 1\ x A. v BAXTER No. 2-,GM SUM "re—ST qB 8 Q9.0 1 ToP ��Ip.sllb0.0 Q_ ; q-�Oc�ri//i�.T, y717 ., ii aPiPb d LOAM. - P� ; luv B loan IM/. 9c.7o + sue Saa_ 4'�Pfs 'bPsf, IW. GAL. 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THE COMMONWEALTH OF MASSACHUSETTS �., BOAR® OF HEALTH -4�10 ..... ­­............................................ , ppliratiun for Dispuiitt1 Works Tonstrnrtinn ramit Application is hereby made for a Permit to Construct (ffor Repair ( ) an Individual Sewage Disposal System at: .................................................. / cation-Address Lot No. � CC .�tL •-er✓-� ' ---------------•�-----...•.... ..........--.... h` .[�. Z...._..... .� Owner Address a ................... ..: :.. .....�A�_------------------------------------------------ .-.--------------------------------------------.------. � i Installer Address Type of Building Size Lot..42..v ......Sq. feet V Dwelling—No. of Bedrooms............. "'........................Expansion Attic ( ) Garbage Grinder aOther—Type of Building .... ...................... No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ,r(OY�-------------------------------------------------•----------------------------------------------------------------------- w Design Flow............................................gallons per person per day. Total daily flow............ _�" ................gallons. WSeptic Tank—Liquid"capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... W'iidth.................... Total Length.................... Total-leaching area....................sq. ft. Seepage Pit No�l.V0.0� DiameteaddAc-e-, 4eglpth belo� inlet........... .... Total leaching area..O.V.7....sq. ft. Z Other Distribution box ( ) Dosing tank ( `-' Percolation Test Results Performed by...... _ 7 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_-____--___-_-_-----_--. f% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ o T ; z T r -------------- Description of Soil............ _4.1 9�.. r . '.. - vx ----------------- -- .,� . _.... •-•••-------------•. 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 TITLE 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. Sig - Date Application Approved B ... .. ................ ... ... ......,1-2-'--_Z--?-27----- Date Application Disapproved for the following reasons---------------••---------•-••-------•--------------.....------------------------•--------------------.........-- ............................•-•-•••----•---•--......-•-••-•-••--•-----•-------•••-•-•-••----•-••---••-•--••--•••-------•--•---••--•--••---•-•--••-•--------------••--•••••-•••••-------•••--••.......... Date Permit No......................................................... Issued----&-`---= ` Date r � --------. te 0 No....................... i 4V" .............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........OF............... ........;;,.........;............................................................. Appliratilln for Disposal Works Tonstrurtion ramit Application is hereby made for a Permit to Construct (4P'y or Repair an Individual Sewage Disposal S t t d 7 y" -A.................................. .....................A ............................... .............. *.................................................... -ocation-caress or Lot No. ---X2e ...... ............................. ------------------- ................................................... Owner Address ......................................................................................... ...................................................................................6.............. Installer r Address --,,--. Size Lot..62!..42q_!��------Sq. feet e of Building'i Typ, U Dwelling—,. No. of Bedrooms..........................................Ex ansion Attic Garbage Grinder (4t) 04 e r,;'. 'Type of I" u"i I d i nl'g . ..................... No. of persons__...................*....... Showers Cafeteria P4 Other fixtures ......I----------------.................................................................................................................................. Design Flow.....................................:......gallons per person per-,day. Total daily flow............;�ZZ gallons. 9 Septic Tank—Liquid capacity............gallons Length................ Width.........._...__ Diameter................. Depth_-------------- W Disposal Trench—No..................... Wi&tli- Total Length.__..._............. Total leaching area.....................sq. f t. �4 ----------­------- 4 o .... .............. Total leaching area_or Z....sq. ft. Seepage Pit N 6W Diamet,qr%441. . th Belo inlet Z Other Distribution box Dosing-to go nk Percolation Test Results Performed by..... ..............�A . ... ... ...... Date.Ag..t.7--n.............. Test Pit No. I................minutes per inch Dept i of Test Pit--____._____--______ Depth to ground water_______---___--__-_.-_-. f� Test Pit No.,2...............minutes per inch Depth of Test Pit._......._.......... Depth to ground water---------------_------ ......... ......... ......... ------- ---7 0 Description of Soil .. J..f... .... ......... ..-- -----.. ---- - -- . . ... .... ---- .. ..................................................................................V .. ....................... ........... --- ....................... ................................ ­--------------------------................................................................................................................. 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 T I T ITE 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. ... -------- Date ... ........ Application Approved By.......... . ....... ......... .............................. ...... .............. Date Application Disapproved for the following reasons:.............................................................................................................. .................................. ....................... ................. .......................Z.�........... .................... ----------------..........................V Date Permit No......... issued......... ................ ............................... ---------------------------- Date THE COMMONWEALTH',OF-MASSACHUSETTS BOARD "OF HEALTH ­-77 ............. ....... ... .... I.......................................... fi OpWrtifirav of'Tomptiana THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed V,��'or Repaired by............................................ -- - -------------------------­­­-------------------------------- --------------------- ---­------------------------�­ 'r,' -4. e -;;�4,� I- Ain;iali; .............................................................. ..... .... .. at .. ... has been installed in accordance with the provisions of - T 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.W! ZF;jV .,--------- P. ...................... dated..../A.- ........................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM 'WILL FUNCTION-SATISFACTORY. DATE.-- •. ........................................ Inspector..... �..-'...--------•- .. ...................................... THE COMMONWEALTH OF MASSACH TTS T BOARD OF HEALTH L-7 ,4 .... 6�0 ..........OF... .......... No......... FEE... ......... Dispnoal ;Narks Tonstrudion "pamit Pertnissionis hereby granted.............. 'T.........V..... ............................................... ........................................ to CoryqWt (I,- di id al Sewage Disposal, System Rep4lV.-( ) an ivi u ,at _/. .......... ............................................................ NVJ.L.. .........................V 191'reet. as shown on the application for Disposal Works Construction Per g**o N Dated / ----.- --7-7---- --------- e .......................-. Board of He DATE................................................................................. FORM 1?55 HOBBS & WARREN, INC., PUBLISHERS il\ J O Z d h o %J o I A c Q v ® W Zi C N z O 7Z Q c lk ac �j ac Z ® W W O _O + W CC � V F. c9 W Q �3Q H J W W � >��. �� �� V � + . �� p v 3 � � � a � �� �� a •