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HomeMy WebLinkAbout0051 POPLAR DRIVE - Health 4s r•, % ATo.�. .:. Fps ................ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ................oF........ .c9-RN..S--. �-�-C._-............---------•- Appliraa#iott for Diipnial Works Tomitrurfilatt ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: . ......b ...........................................z . ..------------------------�- f -----N-. ............e© - o. -•-- W .............. v ......... :.. � c�_ T� io re � `� � ----....------....eaort�t l�c-----------............... Owner l Address J----- . P'a Installer Address Type of Building Size Lot..... ____Sq. feet a Dwelling—No. of Bedrooms........ ...............................Expansion Attic W63 Garbage Grinder VC10 p, Other—Type of Building ............................ No. of persons........42................ Showers (c;-) — Cafeteria ( ) Q' Other fixtures ---------------------------•-••. . W Design Flow.........5.45 gallons per person per day. Total daily flow...........3.3.. ...............gallons. WSeptic Tank—Liquid capacity.1.00._gallons Length---- Width....Gt........ Diameter..._.._..... Depth................ x Disposal Trench—No.........I........... Width.................... Total Length.................... Total leaching area... 4. ..sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (vj Dosing tank ) a Percolation Test Results Performed by..___._ __�_( _iZ 1�. �4.... �1�/��1 1. ....... Date.....- Vater 1�/ a Test Pit No. 1......__ ...minutes per inch Depth of Test Pit-------lam._._... Depth to ground ______tV N _-. _NCOV41,e Gz, Test Pit No. 2:...............minutes per inch Depth of Test Pit................... Depth to ground water------------------------ •---------------------------------••-•--•------ ......... ................................................................................. Description of Soil-....6.---°t...•-•-I- -�-----"' ........ .................................................. U ............................ ......1.v........ -----------••-•----•-•--•------------•--•------••----------•--------------•------------- 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 TLI'ILE 5 of the State Sanitary Code— The undersigne f tl:er agr e not to place the system in operation until a Certificate of Compliance has been issued by the board of 1 h. � pp nn (. I-hc efollowing ned. 15�cYC w��cYt 6 -•-•- --•- .......... 3 �_.�............. .• •••-• •---• - - Dat ApplicationApproved By..... ---------•••••-••------•-•-----•-•........---••-•-•-•..........----- ......-•�-�...�......--- Date Application Disapproved reasons:---•-•---------•----•-•-------------------------------------•-------------...................................-- •..........................•-•----•-•-----------------------•-------------------.......--••----------•---•------•--•-••....•-----•••------•••-•-...........•-•---•---•---•-------------•••-----•-•--.:.. Date PermitNo......................................................... Issued............---....------......_......-•-••-.....--- Date fL i No.. Fmc ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ZAK. .. .......................... Appliratilan for Disposal Works Toustrnrtion Frrutit Application is hereby +made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at,t i �Q i%j'-e'a` QV es `f �: ................ .--•-_... ...---•- ...... ...... .... ................................ o ation Address or Lot No Own r Address .. -..- a _.... f2.f.5. . -��-�•----•-•----•-••---•--•.........:..... ..................•-------.....�3���_cz v�__���'__ ............................... Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedro ...................................................................Expansion Attic W4 Garbage Grinder (/(/cam Other—Type T e of Building ............................ No. of persons Showers — Cafeteria Pa YP g P. �--------•------- (cad.) ( ) Q' Other. fixres ......................... •--- . W Design Flow..........5'.__-•--•................ ...gallons per person per day. Total daily flow...........3_3_Q..................gallons. W Septic Tank—Liquid capacity.W.....gallons Length---- 1.0...... Width----6--------- Diameter_.".& Depth................ x Disposal Trench—No.........}........... Width.................... Total Length.................... Total leaching area... ' .___sq. ft. Seepage Pit No...._................ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (1I Dosing tan ) I '-' Percolation Test Results Performed b tgt .t�l ._. '%G ��l �f�rt ..... Date...._,S� �5 ___.... �1 ,a Test Pit No. 1.-----_._'R_.....minutes per inch Depth of Test Pit....... ........ Depth to ground *later......[V.0Aj4 _.4_4e4VJ1I�tL Gz, Test Pit No. 2................minutes per inch Depth of Test Pit--------:........... Depth to ground water........................ 0 Description of Soil..--a, ...i...1_ ._ - - - -- - - ---- - - O off. C ' U ° 1 ) ° v`1 --------------------- W ----••-•••------------------------------------------•-••••-•-----------------•------••-•-••--•--•••-----------•------------.....------------•-----......---•------••••••••......•---•-•--------••------ UNature of Repairs or Alterations—Answer when applicable--------------------------------------------------------------------------------•--•----_---.-. Agreement: The undersigned agrees to install the aforedescribed Individual Sewa e Disposal System in accordance with the provisions of TIT1,E 5 of the State Sanitary Code— The undersigne f 'her ag e not to place the system in operation until a Certificate of Compliance has been issued by the board of 1 ea h. ��� `c�r Cam c ZigneA,ty�­ ..............�1..••-- • ....i ` D ._......al ApplicationApproved BY -. --------------------------------------------•••••---•-•--•--------.--- ----•----- ....-----------� Y Date Application Disapprove or the following reasons:--------•-----------------------•-----------------------------------------------•-------........------•---....._ --------------------•--......-----------..._-••-•---••-•••••_...__.•••••.....•--•............-------•--...-••--------•--••-•---•------•--------------•----------------------------------•---•------------ Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . r, ),V................. , .:..�t1 T/t.1--9 ............................... . O F.......... . Currtifirtttp of I"fnutpliFaat+rr T IDS IS TQ CERTIFY, That the Individual Sewage Disposal System constructed or Repaired ( ) by.... --------•-•------------------------- --- •-----•-----------------------•--•----•--•-•--•----=------- . Installer at b 4 �t ........ _ - S <.............. T 5 o T State Sanitary d as sc bed in the has been installed in accordance with the provisions of TI � e -Cp �d > application for Disposal Works Construction Permit .............................. dated------------- -____. ............................ THE ISSU�FU NC OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE AS.A.�UdRANTEE THAT THE SYSTEM WI / CTION SATISFACTORY. DATE..... ..1. Inspector s --------------------------------------•_•_-___ THE COMMONWEALTH OF MASSACHUSETTS '�"" BOARD OF HEALTH .........!..M^.................OF..... _ l S L C" ........................................ N ...............;: _ FEE....................... Disposal Works Tonstn tion rrmi# Permission is hereby granted vl.l_ A. f�.s.- `D�t'...............•--•-------------. to Construct (P--for Repair ( ) an Individual Sewage Disposd System atNo. jvf.--- ..- 1�� Liz-- '_..__- 'e...._.._�_1,S �11 -----_----------_----- ------------------------ Street as shown on the ap li tion for Disposal Works Construction Permit No _______ _______ ated ,.__ ' _....._____._.... Board of Health " .- DATE.--:... JJJ 1j ............................................. FORM 1255 HOBBS &'WARREN, INC., PUBLISHERS ' r _ _ L D CST ION SEWAGE PERMIT NO. VILLAGE - A-'k(h 11e IN tT LrL,1R'S N ME i ADDRESS VY ✓� /A BUILDER OR OWNER / DATE PERMIT ISSUED __ DATE COMPLIANCE ISSUED 7 � � in\ �i � � � L. J DLO QTION : 5EWaC4E PERMIT MO. - Lj2tv---�4 L7 -(iLQ !L):.�j-/2 IWSTALLER5 1&NAE 6 ADDRESS BUILDER 5 Q O,MF- ADDRESS Al Dt.\TE PER"VT I55UED =_ LP-- 24 DATE COKAPLI & aCE ISSUED : — "_, I q t . r ` t ® LdT v SnS T a N 3.`' a. ti U° �5 . Q Q SEil 0Qw�vA--K O ' 10, L fl.� 007„Rcsttl ' d SDI' _ war��pp-pmuuE 0 1 L® C. � Psic,wr a T ` asr.r3ox w 1� f�r < i 4 9 f 1 1 o a � 1 i 71 15 L oZ y. - ���7 3 7 1 f-.5 OF Mgs ~ �4�C .ti is.,000 s F' Q�STB� Q` SURN�y� LEGEND CERTIFIED PLOT PLAN j tN OF M EXISTING SPOT ELEVATION OxO _ EXISTING CONTOUR ___ 0 --- o`'' ALB c L®� �{/ cJr''1<► ' 7J,e1�E FINISHED SPOT ELEVATION FINISHED CONTOUR 0 U E y o.10951 N APPROVED s 'BOARD OF HEALTH o FGIST ',t ` FFrS/ONAIE�� J i�1i�`� � '1.N w �Ji� i�✓r DATE AGENT SCALE$ ��3= .40 ' DATE, 4%-4193 LDREDGE ENGINEERING CO. INO �AYs 1oC CLIENT- I CERTIFY THAT THE PROPOSED EGISTERE REGISTERED J0® NO, F3_ 049 BUILDING SHOWN ON THIS PLAN CIVIL LAND CONFORMS TO THE ZONING LAWS ./i'I. ENGINEERS) OR.BYt A.A SURVEYOR OF BARnSTABI M Ss. 712 MAIN STREET CH. BY. N YA N N I S, MASS. SHEETJ_ OF I DATE R LAND SURVEYOR. _r a � /Y07"E' /_�c'.�EITNER THE SEPT/C TANf�. OR m. 20 FT,. ..M/N: p ,i Eff Ct//wG` P/T A RE MO RE 7f/.9.4/ /2"BEL0 JV zRR0E� f� 2Q"O/A W ETER CaNG'RET� �'C)iiER /O fY`M/�/•.. SNALL QE BIWOC/G.NT TO GRA,OE. C:ONGRCTE,:. .Q q''PYC P/PE J'�ERYy CAS7' /RON COVER Si/.4LC_ QE USED MP/TCN" . DYERS i 2 . MiN.. CD/VCRL�-TE -- G,�,4pE CO"VEIL• C•L EAiV SA V 0 &ACSC�/L L 2*LAYER RONP/ ot� o� O • .•• G s_ e A HFD TD E �S �T D/ • • • e• • TA/VEC . . BOX . n � • . $ • . • i • ° a . ♦ • •' •s / �. .� n � • •EFFECT/VE ° • • • 3 4 - � �2� e ° • • DEFT • • • • o WASRA STONE = '/Ya i aI r • • •` • • • • • p •• PRECAST SEEPAGE ? Y 1 . q • . • • • • • r • • a a e. P/7 OR EQU/V ; !Ni/PRT ffLEYAT/DNS /'lT Gs412I14C-!T� S� bra � �/. • a 'rG //4►9/ERT AT OtlILD/NG.., l O Z Pl O/AJ�t. ; T (sEg •aaul..a r�ow�-::, },. 1/{/LET..SEPT/C T.4NK 10 Z 3 FT Y OUTLET SEPTIC 7AN/< 10 z•� .FT. O/STR/9!/T/ON BOX f 0 1.9 SECT/GN OF ,. GROUND J4rj9TFR T LE OtJT1.ETD/STR/Bt/T/O/V 6OX I FT - //yLET LEACN/JV4:P/T= " ot� FT SEWAGE OI.S�6ASAL:SYSTEM, : .TABIILAT D LEACHING PIT / N 6 -�S cAL E' 14 s. j• o r D/HENS/ON A _ T.aN F DE5/6X:•CR/TER/A D/�"/•E S/ 8 _ ;�. EDROOMS .3 D/HENS/®N C 4 FT. ny ird. ER OF B NllMQ G�ReAGEDlSP03�1LUN/T ���� - SOIL L.O"G � , O/L TEST . S AL.E3T/MSTED"'FLOAT! 33 J G.4L- DAY. SO/'L. TEST ! SOIL 7FST 2 I TO T � _ G FLEK 1•Y, AT OF SO/ � T ST NUMBER,Of �`ACXtN . PIrS _ 0 E L E f S/DE`LrAGH/NG.PER P/T' Ski RT. ,RESC/LTS 1V/TNESSED BY J1 13 BOTTO/HL6ACi//NG PER P/T 7� SQ. FT L - PE�itCdLAT/ON RRTE ' / 5~,M/N�IINGN O c. �i TOTAL LEACHING AREr4 2 6 .S'Q FT_ , jS 0/L . • JaE�COLAr/ON RATE�2 Z 2r Q .QESFR►iE6EAG'/'t/N6AREAFT. / Z �, . 5oi� -r�sT 2cF a t-A Of Al -�N OF M4ss � . .,. 5��� � AL iA � rn RSE co INC 4 -i - w 2SB74 0 . p No.1095i�Q EL DREDGE EN&I HIEZR/h/G CIO . 712 MI1/N"ST. r y yq t/N/S, MAS1. t � a C E /D N V. .a :.,...� E. TER' E CD NTER�O -: ;4. S .. 4 2..G/c� s � S.uR a �. ;• •, (,$j- .ND GRO[JNv' YNi4 N. U CL/ENT. L3 y ,DATE � �' GROu/VO IVA"TE.P AT ELEV- —_ 8.3 Sfd 9 EFT_ - JOB No: