HomeMy WebLinkAbout0031 ROBBINS STREET - Health 1 �-�-� � �� - __ - -- - ._--- _____ _ _
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No.................
--�-----�_.. . ' ate....-:3......�......
THE COMMONWEALTH QF MASSACHUSETTS
BOAR® OF HEALTH
.............. ............OF......1 ,........... ------...........................................
I� 6b(° Appliratinn for Bi_qvniia1 Works Tnnitrnrtinn Prrutit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at: _
4,117.2w.
Locati Address n t No.
Owner Ad
Installer Address
U Type of Building Size Lot... 7_. ._._Sq. feet
Dwelling—No. of Bedrooms-__-•-_-•_.�-----_----------------------Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building No. of persons............................ Showers — Cafeteria
Pa Other fixtures -------------------------------• -
W Design Flow...... ............................gallons per person per day. Total daily flow............Sap...................gallons.
WSeptic Tank—Liquid capacity...d��.gallons Length.__ ____.___ Width.....y....... Diameter________________ Depth............
x Disposal Trench—No................... Width.......---------- Total Length------=:-......... Total leaching area-----_r ..........sq. ft.
Seepage Pit No.........'_.._.------ Diameter.._.. Depth below inlet......4?_.......... Total leaching area..:.-2.49.,�7..sq. ft.
Other Distribution box (k) Dosin tank )
Percolation Test Results Performed by--------..........
__ ____ ___ e � � Date....25.)'``" .- 9 77
,a] Test Pit No. 1.._.e -___minutes per inch Depth of Test Pit------_2._...... Depth to ground water_-__---------'`----.
i, Test Pit No. 2...:�. ..._minutes per inch Depth of Test Pit------1 Z-------- Depth to ground water..--'*'--- 'ti
a •--•-•••••---------------------•••-•----•--••...-••-•-•-•-•--••-••................ ....•.. ° -•-•--
De i tion of oil....
...............e....
...............................................................................
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 ITI.1'^
: 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. r
Signed % 1' z---------- -----�_0-- ?�
Y Date'
Application Approved By......
1 _-: '.------
Application Disapproved for the following reasons-------------•------------•---------------------------------------------------------------------•.....*-------•--
--•----•-•--.....---•-•----------••-•----•-----------------------•-------•-----..._..........-----------------------------------•-----------------------------------------------...-•------•---••-------
Date
�0
..... ISSUed b- ..........•.......
11D
Permit 0...-•--------•------------------------------------- ate '°•
Of
No........................ FEE.. ...............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD 9F HEALTH
................ ....._OF...... ..............................................................
Appliratiou for Uhipoiial Works Tom3trurtivit Vrrmit
Application is hereby made for a Permit to Qonsttuct or Repair an Individual Sewage Disposal
Syslem at:
................................................................................................. ...............;........J.. .........................................................
Location-Address Lot N
re'aau or CLZ�
................................ ......................�...................
.......................... "'e
we r,,
...... ............... '� ;
Installer ------- ----------------------------------------------Address---------------------------------------------------
OP
-- -------------
Type of Building Size Lot____,./ ...Sq. feet
U
Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder ( )
P4 Other—Type of Building ............................. No. of persons............................ Showers Cafeteria ( )
Other-fi,xtures -----------------------------------------------------------------------------------------------------------------------------------------------------
Design Flow....... ...............................gallons per person per day. Total dail), flow............ ......._........._gallons.
W
Septic Tank—Liquid capacity............gallons Length----9�....... Width..... I....... Diameter---------------- Depth... ......
Disposal Trench—No- ............-------- Width................... Total Length------=......... Total leaching area------=..........sq. f t.
Seepage Pit No---------I---------- Diameter........ ........ Depth below inlet._.... __......__. Total leaching area... -:5.......sq. f t.
Z Other Disqibution box ( YQ Dosing prik
4
,bp, M '?7
Percolation Test Results Performed by.J�---------- -------------------------- Date_._.....-2........4.......................
Test Pit No. I..... ....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........................
- ------------
....................................................................... ..............Z�................... ......
0 Description of Soil......... .................. <5
................................... ------------------------------------
17
U ---------------**------I.. .. . ..... ........................................................----------------------------------
7.........................................................................................................................................................................................
U Nature of Repairs or Alterations—Answer when applicable----------------------------------------------------------------------- ........................
........................................................................ ............................................................................. ..............................................
N
Agreement: if't
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of T.L T.LE, ..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.
Sid... ............... ................................
....................... ............ ... .......... I
Date
................................. ......
Application Approved By------- _,4 -------
7 - V Date
Application Disapproved for the following reasons:...........................................................................
......................................
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------.............................
Date
PermitNo........ ,Issued_.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.......... ............OF.....................................................................................
T rt-f- tr pf Tout Hatta
y ....... --
THIS IS 'rO-)6ER TIF Y, T' 'I.ha the 6'�Vidual , e Di constructed or Repaired.. . .... .... ............................
.. -------:7 . .... . rsea l fl e r
t
..........................................................at,.... ....... .................vj ........................ .......... .................. .. .....
has been installed in accordance with the provisions of T 5 of T4e State Sanitary Code as described in the
application for Disposal Works Construction Permit NO. ....... dated------- ----- --71 ....
THE ISSUANCEOF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM, WILVFUNCTI9N SATISFACTORY.
DATE... ..........---------- ..... .......................................................... inspector
THE COMMONWEALTH OF MASSACHUSETTS
BOARD r%m HEALTH
L71)
. .............. .................OF.....................`............................................................
_N FEE........................
Permission jahereby granted--------- � . . .. ............... ....... ......... ...............
to ConstTlSt Repair ut 1.Sew g spo G `
at ........... .. ...W.'eIN., ......................... ............. ............................................
No.J
Street 7�.
as shown on the application for Dispos4'"V rks Construction P Al..,: ated..........................................
Per c
. .......... .....1.--Z'
.. ............... -------------------------
l3oard of Health
DATE---- ...�7-
...........................................................
FORM 1255 HOBB S & WARREN, INC., PUBLISHERS
--r� 1 7 c - j- r, �o • oc TYPICAL SYSTEM PROFILE I
AREA PLAN L),Tl#�L RuH N S JT. L ( U r J. �. FINISH GRADE=�� NOT TO SCALE
'' ------- FD N TOP �— ..__
- - c•� FINISH
SCALE : I 3`, /VOT / t,1 T f--�k- FLO0-0 /--1- A ���' FINISH GRADE OVER TANK= -���� OVER
GRADE P I T
VF _ f
PVC OR O O ° • • • • o 0
`.,�C. 1. TEES
!F,7 -
• Y
ti�j'� ^•� i '�EX i.5� --- .5/. 00 � SC?•J(.J K..o.� .: :o-� `e.-.•. .� • ` a.:. v • e o • • • e •
Lt� r;,�/ BSMT W�.C�(J DODO
* FLR` L. 4 .�'�� :_� o • o o • • • t o • o e
.-. REINFORCED DIST. BOX "` • • • • e `'
TO BE INSTALLED ON
j CONCRETE 8 e • • ° • • • • • o o °
I
95..Ea A LEVEL STABLE BASE e ° a ° e o • o e
�rf S K i — ° e o • • • I • o o ° o °
T
=so co r Ass u�+i:�_)j S E P T I C TAN K
TO BE INSTALLED ON A °
F'-'' LEVEL STABLE BASE ° o • • • t • o 0
C
2 -I/8 - 1/2 WASHED PEASTONE ALL
U,G,07%LI T-1LZ /z' !, AROUND FREE OF IRONS FINES ' ' ° • 0 0 0 °LCC c7T/D/t! �(-! �' ,-` BRICK a MORTAR COURSES AS
rvy '�/���'7' L' ,I �'�� ` - REQUIRED TO BRING COVER TO GRADE
� AND DUST IN PLACE LEACHING PIT
24 "C.I . MANHOLE COVER a 3/4 " TO 1 -1/2 „WASHED CRUSHED
FRAME - SEE DETAIL STONE ALL AROUND FREE OF BASE TO BE LEVEL
IRONS, FINES AND DUST IN
PLACE ( I f� ':,1i,J.1
1� II FOR FIN. GRADE
SEE SYSTEM PROFILE SOIL AND PERCOLATION
I� = 14„ ji I DATA
— _ - - -8„-- -- - - - - — - PERC. RATE : < ' . MIN.�IN•
„ o FOR INV. ELEV SEE ELD�'E c E Eti'G�yr Fkl.� ,
INLET _ • SYSTEM PROFILE 6„ TAKEN BY .
LINE o . - 0 WITNESSED BY:vs+v� ue✓a�,o r Hn.4ti`rs: E BD v� PFPi r
vy I ° 0 OPENINGS W/4-1/8 24 J vti E If
OUTER DIA. a I -3/4"� DATE
° °
a _ - 0 INSIDE DIA . 0 ° 57. �• 55..;.w~
�,, 7 _ ° TEST PIT-GLAD ELEV.
6 - , ' _ p o TOTAL p 7,, q, 7W 0:L
3' o p
AREA o o �. _ cti� ,• �. NG. r: U.�r /Ev4E
° ° 0 0 0 0 5 F' p 0 0 SUES-SG/L. �LAb-50h, OR WA A ..
vll - t
• - o 0 0 0 0 0 0 0 _ CDH�cS
,q — p
>l _ e.
� . STAC . SET 0oeoo o 0 0 it
-- ----- =--
'
jNrA!J L.OT#92 � 6 6 , DIA . _- 7 • —..
sc� 2/0794fl
/0 �, EFFECTIVE DIA. BOT. PERC. HOLE
DOWN
LEACHING PIT - SECTION r
,`'`� -✓ NO SCALE DESIGN DATA :
�.� NOTE' DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM NO. OF BEDROOMS 3
54 �, ��,;. '20 DISPOSAL
TP #I LEACHING PIT NOTES: EST. TOTAL DAILY EFFLUENT `�`"' GALS .
�3• \ `fa 0�7.15 , l e+ SEPTIC TANK 100
..� GAL.
,o � ,, s. _ Z33 — 1 � I . C 0 N C. TO B E 4 0 00 P.S.I a 2 8 DAYS .
r KNrr �. i �, 3��.aU�. �� 4'` a, '�� �.) 2 . REINF W 6 " x 6 " 0PIC6 GA. W. W. M.
V
�5•�5 • \' % G'ti v- `'�� P7 3. 2 'AND 4 ' SECTIONS ARE AVAILABLE FOR
U � fir,,\.�. .., �.(s��.� � GENERAL NOTES
` 54.,�\s GREATER DEPTH REQUIREMENTS
1 1 . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN
'� --.,��� \ \ '` 0 9� \ R\•� 34 S� . NOTE ' ACCORDANCE WITH TITLE5 OF THE STATE SANITARY CODE
EXCAVATE TO ELEV. 4 OR LOWER AS DATED JULY 1,1977 aANY LOCAL RULES APPLICABLE.
REQUIRED TO REMOVE ALL LOAM AND CLAY CONTAINING '
' AA/ � R " / o�"�*�-' `qQ�, �•' \ 1 2. ANY CHANGE TO THIS PLAN MUST BE APPRD. IN
JV1 ' `' ' , _ iC", PAE3r \' MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL WRITING BY MR. CHARLES D. SPOHR.
'¢ `� ! 3, -- WISH CLEAN,CLAY FREE GRAVEL, MECHANICALLY
e- COMPACTED IN PLACE. 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING,
/i/,e W// L /A�l.' J. h'��� S �t'f ~°f� S 1 , s „� NOTIFY THE ENGINEER AND BONnv OF HE 4LTH FOR INSPECTION.
'� ,r ,,., s,� SIDE L`REA = S. F. S. F./GAL GALS 4. FOUNDATION ELEV. MUST BE CHECKED WHEN COMPLETED.
�9 k0s 4EEv Vim BOTTOM AREA= S. F. _S. F./GAL S GALS I
y'/t�1(�LJTf-!� 1�1�, 02/g ` S�r TOTAL AREA = �`��' S F TOTAL `5 ' GALS 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT WRITTEN
APPROVAL BY CHARLES D. SPOHR.
6. FOUNDATION INSPECTION READ. WHEN EXCAVATED.
` � ��'�\ LEGEND r
AREA PLAN : + 50.G , EXIST GROUND ELEV
- "
I k M1 f-Y-f�,�t, , �00 50.0 FIN Sf GROUND ELEV. UNDERLINED
�lMr
fin//, //�J �uT1E1�fL1-C ��//�/;a � L�T 92 �D REV DATE DESCRIPTION
`.� /� d �••� „ /, /DOG' GAS, /�l�"r'A.;T ;"C.)rilCf?ETE' SEA TI G 4 7 5 0 PIPE LA V E R T. ELEV.
/��U�f�/cS �c'''7�� !`,,� sti�•If�C / -= .`€r` /7 �:r I� Tf�Alk \,.SE�: f-',1�'ni-'ILA
/vL./4kUS S0A;t4,5Y JA,/C . � - O TEST IT LOCATION SEWAGE DISPOSAL SYSTEM
P '<��T COA!G/2E TE Ups�7118UTio�v
F O R
r.E P TANK
MR. WILLIAM J. HAYES
Fe,ck T CG=p,'CAjErF 4EHCHIA16 /='Ir- /,eFQD , [] ST R I b I T i O N BOX
B. �` T E = sF �4 ��;,;,5 � P,�UFILt �F MASS:; LGT 2_ R C;'B INS STREET
C 4 C. i F PE
- f �h ��� CST ERV I L L E MASS.(3,4,5 i� OA/ „ CharlQs U.
_ -tttt-t-ttt-1— 4 BIT. f=i 8 E PIPE -- TIGHT I G H T JOINTS I N TS � SPOHR � I ' �
/e/4�/�fST1r���- L /�C'�I�I-� �d�/�/��i ' r`v''� I�1 ` '. p No. 7468 0; �„ DESIGNED: C•D.SPOHR DATE/ A/OV. 7 DRAWING N0.
fJS T F� C��, C G / J•�' t���V• _.% , r'� -- —— — PROPERTY E z i
o�C/STE� ��%
C;"+ SCALE:ASSHOWN I I I DRAWN: �.. 9
MAP SEC PCL LOT HOUSE MIN. O[ DI . LACE CHECKED: C. D. S .