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Home My WebLink About0079 CHOPTEAGUE LANE - Health 79 Chopteague Lane Marstons Mills A= 012 010 I f i II 1 i i p- j ESSOR'S MAP NO. lZ PARCEL ld ii L La t �'ON Z0 c� 42 U-C La v.� SEWAGE PE 6 6 I T N Q. VI L L AG E HS E , -74 � INSTA LLER'S NAME A ADDRESS o yyt s,4jv,r �(S �O 16 �31 e U I L D E R OR OWME1a_PO.g� cUti 3 DATE PERMIT ISSUED D A T E COMPLIANCE ISSUED A4� l.f Q0 y �p tia a VVAC- �� ASSESSORS MAP NO: f PARCEL NO.: � ; >F�$.......................... 1 0 1 1'71j� THE COMMONWEALTH OF MASSACHUSETTS �_ BOARD OF HEA TH ......OF........ 7 . .._ac.. l.�......................... ttutt for Miu uiitt1 larks (funotrurtion rrmit ., ,��ltrtt � � Application is hereb made for a Permit, to Construct (L_�or Repair ( ) an Individual Sewage Disposal Systems �z ` ---:. , `_.. C�.... .. � P C_....AL.... .....�� .................. Locatibfi-Ad s or Lo�t per, r / yS. �...1..C2....... _�2 <...[�!.:� ...... --�— Owner . Address 1 .................... 0. . ............................................................. Installer Address d Type of Building Size Lot./_'55'__Sq. feet U Dwelling—No. of Bedrooms___--�---------------------------------Expansion Attic V_j Garbage Grinder (j& aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a Othgj fixtures ..___ W Design Flow...... j _......6�rgallons per person per day. Total daily flow.............. C............_.____._..gallons. WSeptic Tank—Liquid capacity,000-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 ( r Percolation Test,Results Performed by. � Pl'_.. �... 1�!l u'!n_. Date........................................ as Test Pit No. 1 _. .._. .._--minutes per inch Depth of Test Pit..... (.... DeptT o ground water._._. _ .. Lt, Test Pit No. ApA.4 mutes per inch Depth of Test Pit._-t ...... Depth to ground water4 `. ry+ ------------------- ---- •--•-----------------•---•-- -•--..._.........----....----........-----...............-----•.................•-•.--•-- �. 0 Description of Soil...(--- 01 r....� -------------------------•-----•------------•-•--------------------.------------------ x ". Cis-........ I f... ....1M. ._ v ------------ ---- 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 J ITL U 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 thepwqd of health. Signed-- -------------------------- � ........ ApplicationApproved By............................---=- . . ...... ..........A................................ .._....... Date Application Disapproved for the following reasons:.............................................................................................................._ -•---•-----------------------•---•----..............-•-•-•--•----•--------•------------................----------------.......----•-------------•--•------•---•------.................................. Date Permit ------6p-.("O.I.......... Issued--------------------------------------•---------------. Date e•auiuu....�� Fims..................._..... THE COMMONWEALTH OF MASSACHUSETTS . BOARD OF HEA TH . .. Appliration for DioVoottl Hlorkii C anotrurtion rrrnti# Application is hereb made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal ... ...........•... ...... Sy .C�.... - c :. ... r . - .. ... ............... Lmati�Ad s or Lo 0 ._... .9�.. _ ._...S..d............. ..... .........` ...........__._........... _• .-----_._ ..... ............. ...... .le e- .�_. / l Owper Address ... ........................................................... Installer Address S d Type of Building Size Lot..._..�............... q. feet U Dwelling—No. of Bedrooms....... ...........:....................Expansion Attic Garbage Grinder Other—T e of Building ............... No. of ersons.................._..__.._.. Showers Q•I YP g ------------- P ( ) Cafeteria ( ) 04 Oth d ... Q .,V,..-•------------------••--.....------..-------••-•---------------------- ................... Design Flow...... __ _ '_..gallons per person per day. Total daily flow......... ..............gallons. WSeptic Tank—Liquid capacity 11006gallons 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.! 7i-! .. -�;� `� �� jZ►�f'��_� Date........................................ �a Test Pit No. 1�r.-'_. minutes per inch Depth of Test it Depth to ground Water Test Pit No. `_4c:iA minutes per inch Depth of Test Pit.. ! ..._._ Depth to ground water. .. P4 •----••......_--•-- -----•-------------•-•-- D Description of Soil P ._f: +� !.,..Y.... •-•--------•--•---_---•- x ! V --------------------•--------------�---f--' --- cti_3X t_�_r_?'!....... � +" .c......-----...-•------------- 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the s stem in operation until a Certificate of Compliance has been issued by the b. of health. Signed.. ...................4..... ............................ f .. Application Approved By.._....-----� . .----- ..... � �: -------•-------------- ......... -• � �ce�' -•---- -------------------•--•--- Date Application Disapproved for the following reasons:.............................................................................................................. .................................•----...........-•--------•-•-•--............--------------.....................---..................---.....•....----------------------••. ............................ ' Permit No.......C_: ......... ....... .......•--. Issued.....------•---•-•---------------........... a�...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O.E HEALTHH ............OF...... .°! ...................................... Tntif iratr of Toutlilittnrr THIS.IS TO CE$ IFY, That the Individual Sewage Disposal System constructed {.. 'or Repaired ( ) f by C' € =a =��. ------ ------- ......................... Installer , has been installed in accordance witthe protions of TI T IF 5 of he State Sanitary Code s de cribe in the application for Disposal Works Construction Permit No.--�:�.......4. I.._. dated------------- ��'.��.. :-:�r?.... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WIL�uN ION ISFACTORY. DATE................ • " ... --------------------- Inspector... ,1•'�� -.............._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT �.+�✓......................... O F...........7......... .......... No. Tick.......•---. ..... �i��roottl orko otTotrttt#' - n �rrmi# Permission is ereby granted....... A , ' l `I. ................ .......... . .._._. to Construct ( or pair ( an Individual ewage D> sal Sys atN ...................... ............... br� ----... .......... Street �, � as shown on the application for Disposal Works Construction Permit No 601 ...::.:......:....... Date .............. ..... ... .......................:.................._..._..........._ +l Board of Health DATE........... -•-•............................••-----••....._-••-........ FORM 1255 A. M. SULKIN, INC., BOSTON - Department of Environmental Management/Division of Water Resources i WATER WELL COMPLETION REPORT r WELL LOCATION Address Z I)' 20 C`4�-�11 /-,�eR City/Town //1 r' &,a G r I G.S.Quadrangle Map Grid Location Owners 41 h�r/»PS yy Address ,,WELL USE CONSOLIDATED WELL Domestic® Public ❑ Industrial ❑ Type of Water-bearing Rock Other Water-bearing Zones Method Drilled / ALA< a r 1) From To .J 2) From - To Date Drilled 12 (�� 3) From To 4) From To CASING Depth to Bedrock �t r, Length %n Y Diameter /)� Type r"l-?:C l Yr UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials Feet below land surface �/�_ -'Or'Sand: fine®medium Vcoarse❑ Date measured b- I f,- .. Gravel: fine❑ medium❑ coarse❑ Screen: GRAVEL PACK WELL / Slot#_�/_length .from to Yes ❑ No 21, Split Screen(or 2nd screen) r WATER QUALITY TESTS MADE "Slot# length from to Chemical .0 Biological ❑ Depth To Bedrock PUMP TEST Drawdown feet after pumping w days hours at GPM. How measured/] hGrtM i n Recovery.-feet after hours. Y N LOG of FORMATIONS COMMENTS: (On well or water) Materials From To o (b rn DRILLER j� / Cb Y .rig Firm / / AO'k /1 I,IJ.o �IJrI/�l I1Gt Address j�ia.�P!�! k o U ` n Registration No. � Aerator s Signature Please print um y BOARD OF HEALTH.COPY 25M to-95-sWlot 7,bW ARD 0F�tHt r r� ., . ► d�. 1 P.O, H LE T YANNIS MASS 302601 � - ' r 0 / 6'_V 14,0 Vr.S 0 DESIGNING ENGINEER MUST SUPERVISE I /'/ INST ELATION AND CERTIFY IN WRITING � a �fI��NT G�� 'NST,4$•LE THE SYSTEM WAS ACCO INSTALLED IN STRICT o DANCE TO PLAN. a u° 17 Lor s s--ice T y-L 7. a W _ N` a 1 PRZln Z'�Ll, 2! ' 51"y� 3 / °. �J'TADi�S �. r �S /R S•00 • _..._ ..��, _.. .�_ _, _.� _. •__. .., ate —�;�e��w; Ap /A/ �a•ou ui.�oE j �ptSAL SgNi t JOHNCL 9'v JACOB) Z QPPERCAPE-ENGINEERI qG No.814 y . " .. P.O. BOX 616 E: SANDWICH; MA 025 7 WEALI�\ 362-628.1 L. `/7 �w. R/lEQ ` TOP OF FOUNDATION CONCRETE COVER ' CONCRETE COVERS -CA 4"CAS IRON 2'"t.tAX. IL IY MAX. OR SCIIEDULE4d `:4"SCt1EDULE 4'0 P.V.C.(ONLY) -� • P.V.C. PIPE PIPE- MIN. I" LEAC11 o.o !PITCH i/4"PER.FT %' PITCH.I/4*!ER.FT PIT.. " •• PRECAST `—INVERT . PIT ORNG .•. SEPTIC TANE t K DIST. ELY.Y., . : >r EQUIV. VEBTEL. .,I. EL. .�t.�j.. •:,vO., .. GAL. INVERT BOX IN ERT %' �Ww 3/4"TO II/. .�' ELY.�. yy .. • EL�?:.�P.. �,.�� WAS W STONE PROM LE OF GROUND WATER TABLE a 3� SEWAGE DISPOSAL SYSTEM E'`�GOU'`�r`teED NO ' SCALE .P-S83U,�, •• .. . . • SOIL LOG WITNESSED BY: DATE s BOARD OF HEALTH f TEST HOLE I TEST'HOLE Z EL-E,V.:�Q; ELEV..:Y.�'2d �. . • • ? . ENGINEER y� 2 subsaL svbso,L DESIGN DATA NUMBER OF BEDROOMS. . ...�.; . . . . . . . . �y TOTAL ESTIMATED FLOW 4? . . . GALLONS/DAY SowQ BOTTOM LEACHING AREA .1:0 , SO.FT./PIT SAAJ1) SIDE LEACHING AREA . . .141D . . . . SO.FT./PIT GARBAGE DISPOSAL .. '�'. ..(50% AREA INCREASE) TOTAL LEACHING AREA SQ.FT /Z� PERCOLATION RATE iC `ss . 7'. .. .`MIN/INCH ' // .-• LEACHING AREA PER PERCOLATION RATE.. :. ... SQ.FT. ..4.QWATER ENCOUNTERED NUMBER OF LEACHING PITS . .0��'. . . . . . . . .. •• /y APPROVED BOARD OF HEALTH r(QrO /so�<:�?s)°.• 1s .sir-�.-- • • s AGENT:'OR INSPECTOR • ►►.sole -: . oT�p ,C 6J, 4.G4: UP_PERCAPE ENGINEER IN 8i ' F a P.O. BOX 616 E. SANDWICH,' MACI STE�`� PETITIONERS02.53 .. '�•, AN TAI;;W.• 362-6281 ��2►► •'•��/d } f - ®v L. a d �- � E . 20 .E KEW ?N o R. s � ' _ _ f i ka,LT- .coo F S" ram'C-LES C-Ko Lk I � u ' i t�4a, C t tit C=t t e:S i } a i I #l, to. APPROVED BY: DRAWN t � SCALE:. �{ �C"'U Q BY DATE: REVISED , NEW e s 1 DRAWING NUMBER 10 X 34 FMI 011IN&MOCIRAWRWo s - i I, l i i i i a 's t z x "t € k i 1f f • jF 1 i tt 4 SCALE: APPROVED BY: DRAWN BY DATE: REVISED js D { DRAWING NUMBER 10 X 24 PRIWnD 00 NO.1000M CLfAWRtMf• a