Loading...
HomeMy WebLinkAbout0065 WIANNO CIRCLE - Health r a C ., 1 V I L0 CAT IO SEWAGE PERMIT NO. VILLAGE cry 01 Ile, .119- �INSTA LLER'S NAME g ADDRESS Gg UILDE R OR OWNER cc o/S DATE PERMIT ISSUED bail ry DATE COMPLIANCE ISSUED ,p,. � � � � � �� s t '� 1 � �� �� ,�, � s s,. Fxs....0.................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF.......................................................-.................................. Appliratiun for Diupu,ittl Workfi Tonstrnrtiun Permit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal syste.. �tJ�Us�.........be.,........... ................................................ �. -'^-- Location-Add, `� Lot N o. •C�e\.......... ..f t-- \ Own; Address l Installer Address d Type Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms........ ..............................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—Type of Building No. of persons............................ Showers. — Cafeteria Other fixtures ... d . -•----.•....-••....----•-•....._....--•------•••-- 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..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ G� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ �+ ------------------------ -.............. •............... ............. ...................................................................................... 0 Description of Soil......................................................................................................................................................................... w -----------------------------------------•-------------------------------------------------......----------------------------------.........------------.....----------------.._.........---------•... VNature 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'L l'L I, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued b thejoar Health. Si d...... . ......APPlication Approved By........_1 :...• ?= .Axz,,�/A- Date ........ Application Disapproved f th ollowing reasons:................................................................................................................ ...-••--........•.............•--•--•......••---•-•-•----•-•-•••••--•••-••....••••-•---•-•........••---•. Date PermitNo....................................................... Issued._......---......--•---------..........--------•-•-•--- Date NoX.!!t�....... .... FEP............................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............... ....................OF AVVftrafiou for Disposal Workii Toustrurtion Frrmit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ... .................................................................................................. .............4Y... ........ Location-Addr Lot N if&.4A4_;t.0....... A-20"W60*2 Owner wnqr. y Address .......... ...L-CILA.-AlZa.................................... .................................................................................................. Installer Address Type uilding Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder aOther—Type of Building ............................ No. of persons_.____....________..._._.___ Showers Cafeteria Otherfixtures ......................................................................................... ............................................................ Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity------------gallons Length................ Width__._......_._.._ Diameter..._.._...______ Depth................ Disposal Trench—No. .................... Width__..._.__._.____._.. Total Length..___._..__.________ Total leaching area....................sqAt. > Seepage Pit No_____________,-_______ Diameter._......._...__..._. Depth below inlet__._._..........._.. Total.leaching area..................sq. f t. Z Other Distribution box Dosing tank Percolation Test Results Performed by.......................................................................... Date........................................ 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....._.___._____._____.- - ...................... ...............1.'.................-------------------*.............................................................................. 0 Description of Soil...................................................................................................................................................................... .................................................................................................................. U ..................... ...........m.................................................... --------------------------------- ............................................ -.................................. -------- �t ...................................................................... U Nature of Repairs or Alterations—Answer when applicable..........�T.................................................................................... .................................................................................................................... ............................................................................. 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 bee issued by, the oa rd health. SI 0q ..... ..........f4... . ............................................. ...... /------------- A lication Approved By.......... .1. .......................................................... Application DisapprovedXl/ollowing reasons:.............................................................................................Datea......._._--_... . .................................................................................................................................................. .............................. Date PermitNo.......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.................................................................................... Tatifiratr of Tompliaurr IS ISK_C,-'RTIFY, That the Individual Sewage Disposal System constructed ( 01�0r Repaired by... ...... ......... ................................ . .................................................................................................. :;­--Installer .a . ;7... at . .. ...... ......A)_r.....21,eh .. .. ...................................................................y ...I..... ........... I e�i................... as been installed in accordance with the provisions of TULE ' of The State Sanitary C d c *bed in the application for Disposal Works Construction Permit No.y ...........---5.................. .... dated.... .................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. IS IS y.... ..... s � ... ...)Z'a been installed C R n accordance DATE.................................... ....................... Inspector............... ----- ..... -------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................0 F..................................................................................... No., FEE........................ or nnotrnrt#inn " rmit Permission is eby gra 'S' is ...... .... ...... ......... ................................................. .............................................. '�u to Constlruc�4�-' o Repair Individual Se ge is osal System at r-------- 4- J ............................................................................................... Street as shown on the appli tion r Disposal Works Construction Permit .... ........./. t ed........................................... ........ ........ e........ .............................................. Board of Health 2, �211 DATE............ ....e... .. .. ................................................ FORM 1255 A. M. SULKIN, INC., BOSTON At e NOT TO NrCA,7L E TO.o FON. F/N/S// GE'gOE "' F/N/SN G,P�70E OVER • EL. ",,<•�, ,"� f'/n//S/,� GRgOE OVER ^ F'/N/SN G�P/70E OVER O/ST- BOX �:.» "� • ,:_ 7- 7N,t' � ` a../rt L E.QC/✓/N4' .0/T7-177 ,,.; //,0 a/i/f,/ ;..• i/. e`// °'`>jc ' /2��M/N. CO✓E�Q /2' q�PEC,9S7 CONG': O/? BR/C.t- y' MOiPT.47 TO • C - • 4 0 � / J Ap�° I.Yd o0.0.40.�0O o d Of 'a •.� hT,���- •1. i. CONC.pETE COVER .. /2 BEL Oh/ G.p.40E M/N- W T. /00 L B S. 4 11, o'• f"O�P 2 M//1/• o . .,o 7�' v v v.p o°v;pe°�°a•01!0 . v�.P 77 N �4 - �1' I✓/PS.S/Ea0 i d ,°i O b D 0• p 'A 4 V p:•'Q . .r �• Al/IV. p • . Q'aY. .e• . y ./ . � � •0 yd 0 c._ a p ,•� o o L "'OA s �o C.l O,P KG. TEES �• _ .'�i, r I•• �'" •a L' 0 lit •. , o: I, o asOC/TL ET d 6SM•T. FG.p �r.` G�GL DAB/ ;+ OISTR/ASUT/O/V. Ox t3 EL. ;'w*• ' ' 'd //vS'T.qL L ON L E YEL B.gSE � TO /At .OREC�ST CONCRETE j✓.4s/,iEO �o vci o c.PG�.S'.5/Eo �RECF�ST . ° /4/- /O A E/NFO-,PCED ,tl STONE I°, CONCRETE �E c 1• i.� Jt. .Jc; � � �. �:$��.ot9.j�v JO 1 - O / ••V1 � '0 y D • sac .e: '� o' � ' I t•et,�no1 a � 0,o'1�t0 SEA T/C Tir7N� °�► ,� v ,o•, . •-. •'s /NS Tf7L L ON LEVEL B�7SE o , • A ,l o . . NOTE EXCo4✓•�7TE TO ELE✓. /D, S. oR •• G OWER TO ,pEMO VE r4L L L0.9M OR CL�7Y MA�TE�P/A4L BELOW TA/E L Ef+7C.�i1/Nrj /4REA• 2 _ O RE.oLA�7CE EXC.�7V.QTEO M•�7TE�P/AL- �✓/TH 2- O ' C4E.4N'CL,gy-F•E'EE G,p�QVEL. /O EFFE T/✓E O/.9METER GENERAL NO TES /O ALL ELE✓.'S sA�OI�N QiVSl�O Off/ ,4 '� /.ti'' r L EA7C1.11A1 q 4CPI T 20 .1744 AMPIAW.S /iN 3'Y.STE/H MIJS7• BE G'A?,TT'AeaA/ �. OR .TC.NEOUL E- •00 R✓•C. /NSTiS7L L ON L EYEL BASE s� O T//E B 0.4R0 O F• A/Ei4LTN Mu.ST 49 E NO T/F/EO N/.NE/V COA/.S 7-. - /C T/O/V /.S' TE, qR/O.e TO &,,7CA-F/44/NOj . '� J © 7V O OBSERVA7T/ON P/T 47AIY C.NA/aGES /A/ T.N/.5 gLM E T E 0�7.P0 OF/,/E/7L T,Apl AVA/D TINE EN /VEER ` � � J � B�' `' •� �► �ERCOL qT/ON Rr4TE' W.NO SE 3'TigM.Q .,7,o.�EgRS OA/ TiS//.S At�f7N. © M/47-ER1A7LS qN0 /NSTi57LL.9T/ONSfJf7LL 6E/N /V/TNESSEO BY 3 ' -_ 5 j/ X7CC OROgNCE h//TA,/ TA/E S T.9 TE .SA7N/Ti4R Y COOS - T/TL E ✓ o7AI0 L OCA?Z- Aio oL/C.�7B L E �� C / �. QES/G►'N 4DA7�A i - i O NORTiS/ gR.POW/s NOT TO 6E USEO �'O.Q � Nl/M,B ER OF B EOAPODMS � SOL qR �v.Q.oOSES i // //'/� O7. FL o o p i5/f72f7R1.� 20NE C 1 TEST �; J�. i 5 A �s' �,q pB g G'E O/SAoOSAq tL �`�/f L v t /✓ CO 4 O / 109 Y r Cf TO P s 1 V Or!/�I �4 0 3,3 OVgL. n O I✓i4 TER SU�.oL Y To w r, c r i2 y _._ SE.oT/C T u � � -c.'f ?y• ._.. .__._..._._ _ . .qN� REQ L� 3_�� D E�7 CA�s//NG REQC//REO f /, 000 1 N Dim t t' •. 's •f/c T4 n/t - 2 2. /G 1 f s �.. yt S/OEI✓.gG G A57RE�9 /9B S F x 2 6' BOTTOM .gAPEAq B I S.F. x/,O' ' 7 GPO 4 r �O O i M'" Pie c.. t Co.yc. G '00ApO wlOE.D e--i c. .,s t G EGENO � —— ' /�ROOOSEO ELEVgT/ON H k V Y � A � / V � EX/S T/N�i CONTOC/iQ ��` ® OB SE.PViQ T/O/V .o/T e ❑ O/.S T•�c'/BUT/ON B O,�' �a�'�,'.. ,� y e'C->R O.O OSED SEJr✓oW.&- D/S•aOS'A;PL SYS TE"M-._______ __._..._.___ ._ ____. . ._ •....__ M/N/MUM COOS 40/57-•9NCE t21dS�flh'^ 5 04 E/7CAl//J4; .0/7- No. 291,11 k I o o SE.oT/C TANAr S yA N E CONS T 1C TION CO p ; t ZaT *t IO8 WIANNO AaL �, T '• , C/RC L E ASNS rA BL E j A SS•q/oE n/VE[ E✓• ���llDS.sO 7- A04•qN 0ARsEt , `� SA!,Jlrp:f . .oRO.oERTY L//VE 1 28085 f: ' OgTE: ly/ .V:' ,/Y,6.3 �` ' /� SC'4GE: AF%S AV'OTE4D •QO• 4980-V Mq� sic •OL•QN NO. . f