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HomeMy WebLinkAbout0154 BLACKTHORN ROAD - Health ( 's LOCATION SEWAGE PERMIT NO.. VILLAGE INSTALLER'S NAME >& ADDRESS B .0 1.L D E I3 OR OWN EIt DATE PERMIT ISSUED DATE C 0 M P L I A N C E ISSUED � , �x- �( !3` 1p t �� � (� � J/� s''�...,��� ,�/ fr� �.� ____.__--_._._.___.__ C;7 No...... ......... Fmi /S........ ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............. TOWN....--.--.OF.........5AWSTUL114................................................ Appliration for Elispviial Works Tonotrurtion 1jamit Application is hereby made for a Permit to Construct (X or Repair an Individual Sewage Disposal System at: .... Blackthorn Road—Marstons Mills .........................4.5.Q................................................. Location or Lot No. ..H.a......... ...... ........ ... ---?41:7.......H4.14 1•12.5.................................. Owner Address ................. kj..................... ... ........ 10................... ........................ .......................................................... 'installer Address Type of Building Size Lot.......�P.Yj§.9.4....Sq. feet 3 _--------Expansion Attic Garbage Grinder Dwelling--No. of Bedrooms.._._______................------ Other—Type of Building ............................ No. of persons............................. Showers Cafeteria Otherfixtures ....................................................................................................................................................... Design Plow.................1.10..................gallons per bdr,.per day. Total daily flow........3.3.0............................gallons. Septic Tank—Liquid capacityqtqQP.gallons Length..U_-A'.. Width..1.1=19 biameter............. Depth_5.!_:AL_'!. Disposal Trench—No. .._..........._...... Width------------------_ Total Length___................. Total leaching area....................sq. f t. Seepage Pit No.......1-------------- Diameter........;0....... Depth below inlet....U........... Total leaching area.....3.4-0.....sq. ft. Z Other Distribution box ( X) Dosinz tank ( ) Ca-pe Cod Sury y Consultant s3ate.....A/;�VTK............... �4 Percolation Test Results Performed by....................................f-Y............................... �4 Test Pit No. 1................minutes per inch Depth of Test Pit-_______._.......... Depth to ground water. ........ = Test Pit No. 2................minutes pe- inch Depth of Test Pit.................... Depth to ground w --ok.pf. .........................................................A,...............= . ......... 4 ROBERT 0 141, — . ............. . . ...........V:............A Description of Soil.......;jk.lt..... V................ =.A...... .................Ir2.........1.21.:=....... ..) _ . . . ...... U .... ... =�X-------------------------------------------------------------- ------EMYtoir ...................................e................................................................................................................................ o -,p•-Flo:,2'X7al;U U Nature of Repairs or Alterations—Answer when applicable..................*............................:.... ..... P. ----------------------------------------------------*----------*----------------------------------------- n Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TL I Ti 1 is 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. Signed....�V ---------------------------------------I---------------- -------------------------- Date ApplicationApproved By.................................................................................................. ........................................ Date Application Disapproved for the following reasons:......................................................................................... ...................... .........................................:............................................................................................................................................................... Date /_2 7)P- PermitNo......................................................... Issued. ... ........................................... Date :4 7r�dA21 ...... Fims.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................T09 1.---.....O F.........BIMS.TABLE................................................. Appliration for bispooal Works Tonotrurfivit Prrmit Application is hereby made for a Permit to Construct (x ) or Repair ( ) an Individual Sewage Disposal System at: ...........Blackthorn Road%Marsto ns M�),Jg- .......................................... 50..•-•-•--••-•••--•••••••..._.......-....-••---•-- Location-Address or Lot No. r` y -------------------------------- f Owner tdd ess •---•------•--•--_-___ -$.. ya1.__lti:!................................................ ....__......----•------ ry ;;P% _-........ ____________---______-_-----------•---- ._....... v Installer L Address 20 604 q d Type of Building Size Lot.............t..._......_..S . feet aDwelling—No. of Bedrooms............ ..............................Expansion Attic ( ) Garbage Grinder ( ) p4 Other—Type of Building ____________________________ No, of persons............................ Showers ( ) — Cafeteria ( ) Ga Other fixtures -------------------------------- -•--•• - •-- -- • -- W `Design Flow.................. 10..................gallons per-Fngth_8_ V.bd.,per day. Total daily flow........33.0............................gallons. W Septic Tank—Liquid capacityl000gallons Le ._.__6___ Width.. --10`biameter______ ..... Depth__�_'-4_'_'. Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........ Diameter........1Q.._._. Depth below inlet....6............. Total leaching area.....1 0_....sq. ft. Z OTer Distribution box ( 3$ Dosi� tank f( d aPercolation Test Results Performed by. ape ---0 SurV2x120nSUltarit )ate.....8131�77___e ... 1� Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground wate ........ Tes Pit No. 2................minutes per inch Depth of Test Pit....... Depth to ground H•OF ....... - ................................................ •_* y .. ••-•- D Description of Soil...,�_u Q � /ol�h. `"" `''-y"--- aF�...... OBERT G --_._.. .---•-•- omV _.lw.__._la.w_____. ._. _.____ __ __________________________________________________________ V. ......© 1{t __..." Cl* ....................................y........................................ •..............•-•----••--•-•-•--•---------------•--------•-•-----•-•----•-••-----•• ;o -p�Na 237-0t• - --• r V Nature of Repairs orA Alterations—Answer when applicable................................................. N Agreement:_ The undersigned agrees tq install the aforedescribed Individual Sewage Disposal System in accordant with the provisions of TIT? 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. �. Signed_:b�e ..�----------- ----------------............................. ................................ ' Date Application Approved By.................................................................__...---------------------•------ ........................................ Date Application Disapproved for the following reasons:...................... --------------•----------•-----------•------------•------•--•-----•-••---•-..._................_..........._..-•••---------•-•---••----------•--•--•-----•------•--•-----••-------•--••----•••--••-_-•-•- i. Date PermitNo.......................................................- Issued-.------.........._..t....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O2 HEAL/= i' /.B-fw L............OF....................� ..9....-----...--.-__-_............................... Tntif irati of Tontpliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) --•-----...--•--......--•--•-----...---•---------------•-••---------....-------•-••------•-----•----•---•---•----------......_._.._._..._....._-••-•••--•--by_-•---••. �'r- Installer at---- •-•-•----•-.0-1.-............... 3^,•t `� 0 ! f-•-•-•----------------------•--•--._..__.._...._.....------------ has been installed in accordance with the provisions of TITLE 5 of gbe.$ to Sanitary Code ass �cri ed 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.--••-•----------- •--------•----•...•-• f-----•-----------•--............----- 3 30- 79 — Xo, ®d P� / Covety, THE COMMONWEALTH OF MASSACHUSETTS Jac ,, BOARD O HEALTH 60 2/ .......... OF.. �—.�_-l�C. /��� ............. ............ . ._...__......-_....._.. .... No......................... FEE........................ Mapoottl Works Tono#rudion rrnti# Permission is hereby granted........ xs f nf•-•-------•-••---------•---••----------------------------------------------------------------- to Construct (A ) or Repair ( ) an Individual Sewage Disposal System r� at No.. Z .--.5'---xo......�j��6t{�� �����r��- -------;,P'� t�................t' �;,-p ?� � .................. Street as shown on the application'for,;,.Disposal Works Construction Permit No.__,. __.__..______� ��ted______C�_..a..____77............. k y� ..........7-*---•••••----------••--------•---------------------- .......... 1 DATE. l 7 •_____ � Board of health FORM 1255 HOBBq & WARREN, INC.. PUBLISHERS ' 1 � Y F 1 - SOIL LOO C.4 TC C \I(kl(1�11 1p\V/Nt�JKa�rf//s c/ ��ysVi 7W/�/L /Y /36- / (� 2';.PEASTONE WOO ,Q.•� /� O•Z LOAM 9_FIL^L-— 12• MAX. I To o /Za.2 BOX I..�o n• °0 oA GJ ✓� �Ecc. /1G•7 29••MIN. D /D� GA00 '1 :::at J 1000— GAL. PRECAST OR o 0 r SEPTIC 6'1: o,• BLOCK c o TANK I;'. . o • SEEPAGE PIT 0° I��• , o' v p os °Ooo I 20' MINIMUM , 0 0l , FOUNDATION I WASHED STONE 4 I � 1e w.A T s.+'C. 4 SCALE. �• �'�,�` :,.?�.,C�-.tr.�,/•r�,�-r �-.s<�•- � 10' PQRC. RAYQ >t .u�...p.�ac a....,.; boa—r'Gs7 Q Act'- .rs,Gfl�AG..�irrZ/»vdu�a� i 9 ;ca//O co.✓�o�[.a•.S YU TEST BY : 45pW T'`fe �..,+i,✓G g�_L,ew, o,c T./5t: 7oavti/ TOWN INSPECTOR: x"rxwL- .s-ru/ICl4./ 40'= '� BACKHOE OPERATOR : I TEST MADE ON 7F-101 301, i9 77 DqT� •2�'Gr�STi.r.1Ca.Q�.vi�.3c. 6Yo.�, ♦ of ligfJ'O tSN OF At a I y t j gl ROB EaT a F. No, 201Crd .t Q 01 OiQ_DAYL L• �f No. 4 NO.23744 F� go ' 4�d SUF1�4' sT& L o -7- •4/ /� ti r t f . .0 I1 .� � t �. •1Gon/C< 3.OUTL�7t � 1d w ' C t 13%, tyf 1 � 6 ra i rr- N f • 136 10 r h 139- i33 t { POT- _ 1 ' /000 44t I • .. 3 ��� .1 , , /L 3. o L, �''� I ( l32�0,. /31 se�i?��E ��,� ' ELEVATION SCHEDULE PROPOSED SITE PLAp I. INV. AT FOUNDATION �ECyA®� �v�Tf�a . ��sl�a • . 2. 1 NV.- INTO SEPTIC TANK = /33.74 IN 3. 1 N V. OUT OF SEPTIC TANK = /3.3.5 go .co r 41Soy ny►,� Tq,�,S;�✓;�,G �,a;y , 4. INV. INTO DISTRIBUTION BOX = 1-43-- SCALE I"=2m• ,�•r�o? 9 197.7 5. I NV. OUT `OF DISTRIBUTION BOX /33.37 C 6. INV INTO SEEPAGE PIT = /A2L o CAPE COD SURVEY CONSULTANTS 7. BOTTOM OF PIT �_rc�+i•DO ROUTE 132 HYANNIS, MASS. A DIVISION B_OSTON SURVEY CONSULTANTS, INC. - B. ROTTOM OF STONE LAYER