HomeMy WebLinkAbout0011 EMERALD LANE - Health (2) 168 Blackthorn Road
MarstOl Mills
A = 046 - 042
I
1. 0 CA, T ION SEWAGE PERMIT NO.
13A a 4—�
VILLAGE
kk 2 A,jA Z- ) S T I4-7'12 J
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IaSTA LLER'S NAME & ADDRESS
R U Il D E R OR 0 W 0 ER --37 i u WX1 V'W-4 l
DATE PERMIT. ISSUED /77
. DAT E CO-MPLIANCE . ISSUED Z 7
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LCC,LLTION SEWO.C;E PERMIT MO.
�/ILLAGE ���11
INSTALLER 5 1 &NAE t ADDRESS
- - - - - - - - -
BUILDER5 Q / VAF- ADORE55
DNTE PERMIT ISSUED - - - - - - -
DATE COMPLIAKICE ISSUED ;
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THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
T OWI�.........OF......BARN S T.ABIE----------------------------------------------------
1 Appliration for IlWp aiial larks Tnnitrnrtinn Vamit
Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal
System at:
Blackthorn & Jasper Roads,-Marst .ns .
...........................•--••---......-•------P•---.......-----•--•--------•-••---.....Q... Ai.71s................................4 49..........................................
Locatioona-Address ,t toor Lot No. r
.../.t.�.1 '.L�..O: �.�.t�...__..�.4..f :.... ...... ^-1 !` ��5, .....�2.+�•1-��- ^l f ................
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Owner Address
Wrl ---------------------------------------------- --------•---- A. '!. ..............------------.---.-------------------
Installer Address 21,072
Type of Building 3 Size Lot...........................Sq. feet
V Dwelling—No. of Bedrooms............................:...............Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons............................ Showers — Cafeteria
Q' Other fixtures ............................
W Design Flow............110.........................gallons perbdr.:; per day. Total daily flow......... ...........................gallons.
WSeptic Tank—Liquid capacity 100 0gallons Length._8.'.-" Width..4..'.-1-0 Y)iameter-----"s..... Depth..5_'_-A"
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No....l.............. Diameter.........1-0...... Depth below inlet........Eli.......... Total leaching area..340_.......sq. ft.
Z Other Distribution box (X ) Dosing tank ( )
aPercolation Test Results Performed by.CApe...Cod...Surmey...ConsultantMate.........8/31/7-Z............
Test Pit No. I-----2........minutes per inch Depth of Test Pit___-__--12...... Depth to ground water....nane.........
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water. . ...........
r� •-•-...•----•----•--•---------••------------------------------------------------------------•-------------------------...... atxa.QF�,�s
Description of Soil_._.. See..-attached...P1i 1.........-•-•---- -----•---------------•-•---•-• .............. oz�'1` ROBERT
ti
V ----•----•-•-•---•••----•--------•...........................•-----•••-•--•-•-••••••-••••••-•---•••----•........_.................. F.
W ••-•--••-•-•----------------•-----••-------•---...-----•------........-••--.._......-•-•---••••-•-•----•--•--•-••--•••-----•-•••----..................•........... o.......
c DQYLM--•......
U Nature of Repairs or Alterations—Answer when applicable................................................_......... ........f 237?YO_-l= ---
..••-•-•-•••--------•-••-•-•--•--------•-•-••--•-•-•-----•-•-•---•••--•-•--•----•--•--......--•-•----•••.....•------•--------••-•---•-•----•-•--•••-•-•-•• -
Agreement: '
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in th
the provisions of TI'ILE 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. ........ .................................................................... ................................
/� Date
Application Approved By................ 4 --- •- 9-`?�=---?-7.........
Date
Application Disapproved for the following reasons:................................................................................................................
-------------------------------------------•-------•-----•--•------------•-----------...---•-•-•-•-•----------------------------------------------.....................................................
Date
Permit No......................................................... Issued....................................
...................
Date
„_ j
•
.ems- No.... F>c$....l., ~'—�..._.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
T.O.[h11�I.........O F.....B-IMSTAB.LE---------------•--------------._...............-----
Appliratiun for Disposal Works Tonutrurtion "rrmit
Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal
System at:
...Blackthorn...& JasPgr...RQ.gjd�_�4XgtOiLS .Mi.11s-.............................449 • --.........
Location-Address or Lot No. '
P..---.s ca!? .............. .....s.d!� t�....Y.r.l......d. 12�a_�+, as 1 .....................................
1� Owner Address
W8s.... Lij?! ................................................ .................... ..................................................
Ins alter Address 21,072
d Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms............................._. .Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
QI g g -P---.��-�--------------------------•--•-----------------------•-------••----------...........•.....------------
Desi Design Flow fixtures ..........::...''allons er.:. .' �:¢ per day�,,,Tptal daily flow......... 3.Q...........................gallons.
WSeptic Tank Liquid capacityl000gallons Length--!! 5" 'W'idth 4.�-10biameter-_._--" ..__ Depth.-5-'_-4”
x Disposal Trench—No--------------------- Width............._._... Total Length ....._............ Total leaching area....................sq. ft.
3 Seepage Pit No...1.............. Diameter.........10•....-
Depth below inlet_................. Total leaching area._3.40.......sq. ft.
z - Other Distribution box (X ) Dosing tank
`-' Percolation Test Results Performed by.Cape-..GOd...SUSYGy...ColiSUltantVate.........8/31/7.7...........
Test Pit No. 1...... ........minutes per inch Depth of Test Pit..>......12...... Depth to ground water. °
Test Pit No. 2................minutes per inch Depth of Test Pit..'................ Depth to ground wa F...
F+•I .......•-•--•...........................................................'.................................................... ...TmE RT....
O Description of Soil See c1ttlChE'd ply ...... r F:
x --------•-••-----------••••-----•---------------------------•••-----------------..._----......-•---•-------•.---- .................................................... u-------DAYLDR----- y,
...................•----•;•; - ------••--••-----•----_..•---•-•••--••----•----_....•-•-••--•-------••-• --------.....-----•--••----•--•..................--_.... .,$ No:2..... �� ..
U Nature of Repair§ or~Alterations—Answer when applicable._........................................
Agreement
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in ac or anc w h
the provisions of TITY:; 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. �'1 4..
Date
Application Approved By-------- -------- ------------- -'
f/ Date
Application Disapproved for the following reasons:..............................� ................................ --------.................................
...................................•--•-••--•---------•----•---•---•----------•------------•---------•-•-------•••---•----•---•-•. -
=x' ..r Date-'.
PermitNo....................................= -.._.... -..... Issued•----------
Date
THE COMMONWEALTH OF MASSACHUSETTS
_ BOARD OF HEALf/T�H�I`
" ..................
.......... .. .....................................W .......................O F........... -
Trrtifiratr of TompliFanrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (x ) or Repaired ( r�
by------------------------------------------------P....... "°-i`'=' ----•------------------------------------------•---------.....----------------•-------......-----------...------------.
Installer
at--- ----._.7A_fY�A e—a= -; t -------------------- ', ,'t'" t ------------------------------------------------------------------•---------
has been installed in accordance with the provisions of TIT LE � of The State Sanitary Code asdescri ed in the
application for Disposal Works Construction Permit No.................. 1................ dated---------------�_9.! ..77...........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. /�
i�o-—---------------------------------------------------
DATE..............fat,67...---•-•�--------..../_22 .......... Inspector.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTI-I
0 ...............l.ss?Ce'+ . ...OF............................. ._..:...:- .� .............................. S'
No.......6... ............ FEE.. ...-----..........
Disposal Yorks Twonstnution rrmit r
-. ..
Permission Is hereby granted.....__._�'�,._ ���`�.�'%____........_...__...__.._..
to Construct (,X ) or Repair ( ) an Individual Sewage Disposal System
at .......= A c ?� l...!LO........--'?::.:....e t ---------------------------------------------•-----•- ---
Street /
as shown on the application for Disposal Works Construction Permit No ___//2._�... Dated................ 77
Board of Health
FO RZ 1255 HOBBS & WARREN. INC:—. PUBLISHERS
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4 ,, DIST. I �,'. • , 0oe� _ �`r � i3a.fy .
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- BOX e °0 'I �bZ 3
+-I, 24••MIN. -
/b 1000 I� 0 1000— GAL. e o o� '�� •
GAL. I �.,,• PRECAST OR ° °° °I �'L ,ze -T
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SEPTIC 6 , o • BLOCK ° 0
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TANK 1;'.�. ' . SEEPAGE PIT °°
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00 I S� K
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r ` 20'. MINIMUM I6° o• •° — — — — — Io ° H�
11 1 p
FOUNDATION I �ZZ S
1 YE WASHED STONE
I I .✓o�,.w7C1[
l j — SCALE:
�TL +c�wd4C .s.�loc..N -� 'c.•ro..� w•4 s r 10' Pam ma B o yo—•c e-no—r1.y
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o..i �ucai. �% .�777 •Q.vl, co.,/.co,GH+s d•� TEST BY
7.•/E ;3o.,�i.•�cS oc? TOWN INSPECTOR: O•.G s��•ed.s,/
0 4.0/t�i sue••►�S t , .0 3.S �'� r7's• BAC KHOE OPERATOR-:
I-A OF y TEST MADE ON :
p -s Q�'al�'..S^'s�tXs3:9 !�l.� tsyo•C � �
0 ROgERT
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i� DAYLOR e�
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ROBERT
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ELEVATION SCHEDULE PPOP08ED BITE FLAW
I. INV. AT FOUNDATION -
s016
gI�G7A�L �Y�3YG�7 ®G�810q J
4 2. 1 NV. INTO SEPTIC TANK = /3/_ 37 IN ,
3. 1 NV. OUT OF SEPTIC TANK = 310'^0
4. INV. INTO DISTRIBUTION BOX SCALE I°= 20' .5azp7, 9197-7 M
5. 1 NV. OUT OF DISTRIBUTION BOX
6. INV INTO SEEPAGE PIT = 120, 2 o CAPE COD SURVEY CONSULTANTS
ROUTE 132
Z BOTTOM OF PIT = 2 HYANNIS,MASS.
A DIVISION BOSTON SURVEY CONSULTANTS,INC.
' 8. �OTTOM OF STONE LAYER = /Z- , 40
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