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Home My WebLink About0111 CHIPPINGSTONE ROAD - Health (2) 111 Chippingstone Road Marstons Mills' r A= 028-089 J r . .Y F�s..3 .......... THE COMMONWEALTH OF MASSACHUSETTS BOAR® HE f ..............OF......... . ... ,1 ( ... . . . ................................ i I Appliration for Biopoiital Workii Tonitrn.rtion rami# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System ............ at• ,�� £ -- dLli --. � .. r --- w ocation s or /ryiNyso --------------------- Add wn ............ --- ................................-= Installer Address �� Type of Building Size Lot..�!_1..3..'......'..._..Sq. feet U Dwelling—No. of Bedrooms......................... .Expansio Attic ( ) Garbage Grinder '4 Other—Type of Building No. of persons....... .................. Showers — Cafeteria t� YP g P (�) ( ) Otherfixtures ------------------------------------------------••-----•-•---------------•---------------•--••-----�---••-----••-•-......*................-•-•-- W Design Flow................. _____....gallons per person per day. Total daily flow......-�,?_3 ......................gallons. WSeptic Tank—Liquid capacity 2w gallons Length................ Width---------------- Diameter................ De t ___.._...__. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area__&_�-1�--_._sq. ft. Seepage Pit No-----_-------------- Diameter.................... Depth below inlet.................... Total leaching area _?_.... ft. Z Other Distribution box ( ) Dosing tank Percolation Test Results Per b _____________"ofiTes . . .......... Dat ....... _._____._.___... Y f------------ aTest Pit No. 14.2.___minutes per inch Dept___-----/1-1 Depth to ground water___ --___Q�✓ -. f� Test Pit No. 2................minutes per inch Depth of Test Pit-___-___---____---- Depth to ground water-----_.................. ....Zr /1------------------------- e---••------------------------------------------------------------------------------------------- ......of Soil------.... U ------------------------- -----r �/ `"� �/ -- ------ - •---- 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 TITi 1E 5 of the State Sanitary Code— The and g d further agrees not to place the system in operation until a Certificate of Compliance has been ' s ed by the f health. ,Sig •---- ---•--•--•--•----- ------------••-----•-•----- �p� Application Approved By_ -. e� •••ll Oae Application Disapprov f the following reasons---------------••------------------------------------------------------------•--•--------------------.........--- •---•--•-------••-------•••••.........................•--....-•----.....-•------•--•---••----•-----••-...----------••-•-••----------------•-----••-•--•----------------------------•-••......-----• ' Datr -. Perxt No......................................................... Issued......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD !-1 E�► *�"!+...............OF...... .... . -- ................................. Appliration for Uiopooal Works Tomitrnrtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at:/, �,ocation_A s or No .................. 1. = =....----_.... .. ...1�a _:�r... .. .. ............................................. wner � t-.Addr s -- •............. ............ .. : ri ................... Installer Address ` � t Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms......................... .Expansio Attic ( ) Garbage Grinder (kl)(11 Other—T e of Building No. of persons....... .................. Showers — Cafeteria QI Other fixtures -----------•--•---------------------••--••......-- W Design Flow________________ .. ... .........gallons per person per day. Total daily flow....... ......................gallons. WSeptic Tank—Liquid'capacity�lf�-gallons Length................ Width................ Diameter................ De ............ 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 r /q '~ Percolation Test Results Performed by------------- - ----------- ------------ Date-----•- --J---......------ ��,, a�v Test Pit No. 1�-2,,,_._mmutes per inch Depth of Tes Pit------- Depth to ground GT, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water____-__-_-_-____--_____. P4 .---j`----- --•--•-•-•------••--•- Description of Soil--------- U 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 TITLE 5 of the State Sanitary Code— The and g d further agrees not to place the system in operation until a Certificate of Compliance has been s ed by the a f health. . - Signed r r. Application Approved By..,.:._..`:�-+�,� -•-•-•- .- °'-- Date Application Disapprove f o the following reasons-----------------------------------------------•----•------•---•---•-•-•-•••-••---•-•-•...-•-----•••••-------•--- ...........................•............................................................................................................................................................................ Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOAR F HE LTH .....................OF..... /,Il�... .!�'�...............:.................... (Inrfifirttt of Tontpliatta THIS IQ CERTIFY, TlMt the Indiv' 1 Sewage Disposal System constructed ) or Repaired ( ) bY...................., l'1' .... ---------...... 4�_ - / / s-Installer /jam A"� . has been installed in accordance with the provisions of IPULF 5 of e State Sanitary Code s scribed in the application for Disposal Works Construction Permit �'o.._ ._'�. .................. dated_.. ' -_ ___ _ .._._.__._._._. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTR D AS A GUARANTEE THAT THE SYSTEM WIL FUNCTION SATISFACTORY. ........ Inspector.... ........ ----•----------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD F HE T r- C ..� ....................OF......d.. Z................................. .... ...Nl .,._. . NO.. .. �... FEE... ... ............ �to�oo�t Permission is ......... ... . Y granted....___..__ orko -�-.R�f. n-ior ---•------------------------------------------------------------------- to Construct or Repair ( ) an Indivjkival Sewa D' posal SR at No...-•--•- , n i✓E-d --•---•V � � y Street as shown on the application for Disposal Works Construction Permit .... ate ,...........`...........`.................. --------------- .......... ....'` •-------•----- Board of Health DATE...r/---;.---J-a---�-Gv............................................. FORM 1255 HOBBS & WARREN. INC., PUBLISHERS lr 7 A'(1caQ Exl—-Xi,lc, LE-ACf I u6 'Crr �,risT/N� 1�EQ oW►JEa )U LI/ 19, 1 9$'L e N/F ALP.EQT . rk 99. Pao tN OF Mq A,INC-.�1 y,41 �M : ►vi .��rt c -vSTE M a weL.l_5 r Es N (Lot S2) �EF'IuF-i_l �a,V"MftSl�� I00.5 0 , L J a Z? N a aN F L1= -r3-o 2, �,a rip v S �, +eYe2 q4 , IYtA�/ 1, 1 9-7 5. ssia�° 7�sT . 0v a 77 oN N Z PPar�D C'�STE�ypQ' • ' H��(7 Z � 102. T SetoAc r/c J I Q p�� AET:[U: GH,RPT \VAC A• •-�r Jl H /�eCA QEFi I.r__ �oL� ) `�,O S' �!, y �' <Q< r}o CAPPEnYlkAAlf�.- s7il,�cEacrP,u�Prr7- S3. fzcs`i �q/a2 gam( I x 0 -- ;dn�[e�_ PL,AP.-l' (SE: \- Z Z/ Z3 p s,F"' 6 / � - --- ��-�� \ /,1.4FA CN P/Q-tV.T 10 O ME UumC-4^.\-,P.t�J F1Fl nit� .F-ric. -wl fEnnrnl�G I I f Ci>cf�r �� Aa.10LEACr-ut,tb -'�--� . FAf-LIN FnS_"jE FF..C7- '• / Q Pu lLE 11C:Ecous Ge:� '�! D � TrlE V.•SIAIE�WnA2y('OLE i• LOT !�° {-N 3 °/b ' v a �-- -... 9 LET 5-7 5t� — (NACAh.1T ) i BANbnNED F�.YJh11�,tT101\1 �V�C.��r, l�' � ., LEGEND EXISTING SPOT ELEVATION CA ��,r��" OF q CERTIFIED PLOT PLAN EXISTING CONTOUR --- 0 ---- nor cy� L p7-S3 c. �r'f'•'�-c:�i�r�e lc�. FINISHED SPOT ELEVATION A. m"'j_ �i.^r' /� './�• _ S` FINISHED CONTOUR 0 00 ORSE No.10951 O IN ' APPROVED s ®CARD OF HEALTH o�FsslONAL� 41111A Ah 11%lS TA A Ja AM A"* DAT E AGENT SCALE, / "= 4o DATE L®RE'®GE EAIGBAOEE'RIAIG Cat OlU •vE- CLIE.NT,______.� I CERTIFY THAT THE PROPOSED litEGISTER REGISTL440 JO® t 0. ?�?-� BUILDING SHOWN ON THIS PLAN CIVIL LAND CONFORMS TO THE ZONING LAB KNE9 12YRYKYORDR.ISYI 'Q ._. OF BARPISTAB E ASS. ' : AS uo r�D 712 MAI N STREET, CH• SY''J'.�<�' ? H YA N N I S,• MASS• y �•23 S�. /` SHEET.L_OF DATE G. LAND SURVEYOR- t NO7'F �_ %Ei4CN/NG FIT ARE MORE T>d :`/ /�"BEL/JiE% /O W/N SRAOE, ?4`Z7/AMETEK 7-,C- C"OVEA S.wALL BE ,®ROUGHT T'o G�QAD--- -6AN EXTRA CO NGRETE `�. PVC PIPE /y EA V y CA S 7 /F O/v C O{iEI? Sf/.4 L L- l3.E U S EO P/TCH /F/N Z;OR/VELVA Y O' � �Z O COYER.S �B"I�F/Q FT. 2 L TE ?A: G AOE CO rE'4 CL EAN .SANLIqUID Level- .0"CAST MIN.PIOA LAYER `fib' 7-CV ' e 1 • • • a • • 1 • n •4IRON � %q'PER F7 SeP7�/C T�6NK BOX DIST, o yyAbHFO SANE r ?� • ° e / 1 •EFFECT/VC 1 • • i 3 4 - � �2 • ° 1 • • DEPTH o • • ' ° o " ASNED STONE Tic,r :<:e • 1 / • • • • o • • oD a SJ x Z. S 377_ i o, 1 • • e • • • • p ••v PRE G4.S T SEA-PAGE a • . 1 • • • • a o • • e o P/7 DR EQU/V. /l4/VEKT &LENA?YONS /V/T CA PAC/Ty �y O GAL�D�� • r a EL.0 V: 9 /.D /NIYERT AT E[//LD/NG 98,5 FT G t-r v�ia�r. INLET &WPrIC 74NK 98.3 FT, / FT v/AlM. C SEETRdUI�iT JON j. OUTLET SEPTIC TTANK INLET A/STR/AI/T/ON BOX 97.9 ,c;r SECT/ON OF GROUND J44TE1'W TABLE 007-LETv1STR/®vTION BOX 97.7 Fr .SE��gGE ®lS�OSA L .SYSTEM /NLEr LeACMIMa Pi•r 97.o ET -rA8 JLAT/01Y ILEACHI/VG /��T D/MENS/ON A 3 s FT. ®ES/<9Al CfZITER/A TCAL.E : %" _ /=O" D/�l�E/VS/ON 8� MUMQER OF BEDROOMS 3 DIMENSION C -1' CAReAGE D/SPOSAA' UN/T 'V O SOIL. LOG SD/aL TEST TOTAL EJT//-%4TED F' 3.3 u GAG. DAY SOIL TEST / SO/L Tl�STlOt2 NUMBER O r 4 ACH/NG P/r3 / / 0/ . f�U.� Of AwLgY• PATE OF SO/L TEST f)� S/DE L•L'ACH/A/G PER P/T /S) S4t PT. LO RESULTS PV/TNESSED 8Y J R A . E� 60TTpM 1-a4CH/NCr PER P/r---L 13 so. A PtRCOLHT/O" RRTE,*/ LZ r.s !�J/N•I1NGr TOTAL lEACH/IYG AREA 2-6 4 SQ. FT, z`- S PERC04A7'/0N RATE AE2 MIN-1/NC RESERI/ELE,4CNlN6AR-=A 2 b-t Sip. T.P ~'E�' SA�� r l v P�cF\ 0 M�`! C- FP OF�qS Al CLr'" r. LOT S 3 ci--;%�. /, Z- s v, 0 ORSE v�i 29874 o N //, � R G O L k+ io�5i o C EL DREDGE ENGlN C A9°c�G/s��<� � ��'D SUR�F� CL 87,0 7/2 )"AllyST. , HYANN/S, MAss, ON NO GROUND YYATE°N ENCDUNTEREO CL/E/VT:l3.AySi�L DRTE 7 z 3 E i Q GRO UNO L�/ATER AT EL E�! ,JOB ND,• l ZS' SHEET OF L