HomeMy WebLinkAbout0091 JASPER ROAD - Health _ - 1 Jasper Road
Marstons Mills
- - - - -- A= 047- 027 1
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L O CATION SE W A G E PE I T NO.
VILLAGE
IN.STA LLER'S NAME $ ADDRESS
B U I'L D E R OR OWNER
�o � �����►11��?�:t�/��S P ��/ice
DA T E PERMIT ISSUED ZZ2 6/7,Y
DAT E CO-MPLIANCE ISSUED �� ?�
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No.........3.f..•--•• FILE.....2...e..............
THE COMMONWEALTH OF MASSACHUSETTS
a BOAR® OF HEALTH
q ................oF..BdYn.-$.'f,0h.6----.............-----..............----...-----
V Appliration for Uiipnsa1 Workii Towitrnrtion Vamit
Application is hereby made for a Permit to Construct (i--f or Repair ( ) an Individual Sewage Disposal
System at
W �... •-- !L f �k1— �•1c. .-•�Dl�l�f
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jP� :-jQd............................................................. ----------------- ---------------------
Lat Ad ss ? o
. ...............................................ark t?�......
�-!. ne dress.
j...........................................�.fO
S
Installer Address
14 Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms.:_. .......................Expansion Attic ( ) Garbage Grinder (lf
P4 Other—Type of Building PkWJ!Vj....... No. of persons.......6................. Showers ( ) — Cafeteria ( )
<' Other fixtures _________________________________ ................................................
Design Flow......1.149.............................gallons perk 'per day. Total daily flow..•-••••••3 ......................gp1lons.
WSeptic Tank—Liquid capacityl.5 ...gallons Length_ $:{P...... Width...r7.'C�.__; Diameter................ Depth.4-_..._....
x Disposal Trench—No--------------------- Width.................... Total Length............a...... Total leaching area....................sq. ft.
Seepage Pit No.......I............. Diameter.......-........ Depth below inlet......z�......._. Total leaching area...2 .1...,.sq. ft.
Other Distribution box (i�j Dosing tank (
Z Percolation Test Results Performed by .......................... Date_. 2,._d,.t97�__.....-..
aTest Pit No. 1---1.Q......minutes per inch Depth of Test Pit.---��......... Depth to ground wate;iiii'J.�l7� �
,Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to groun ater....................---.
GY ...._----;-------- --ON-- ---- ------------------•---------------------------........-----•-••---.-.. . tN 1iF rbY� .......................
94
O Description of ��.il.------ r- :.. .. ............ ss .................
- ---R.EXWlCK m
V .......
g_.
W ••-•--•-••••------....--•---•...--••---•--••-------••-••-•----.....•=•-•-•----------••--••••-•-•.••----••-••---••-•--•--•......................• �- ----CHAPMAN •... ...............
Cn
V Nature of Repairs or Alterations—Answer when applicable......................................... .........No.27 -- ..............
..............•...----•------..........-----•-•----------------------..................--•-••-••-•-•-•••---•-••... -• ----------•-• .................
Agreement: <
The undersigned agrees to install the aforedescribed Individual Sewage Disposa cordance with
the provisions of iITL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been ' ued by the board of health.
Sign d... t
Date
Application Approved By.........•• -•--•-.... .. . ..w<ll4. ..
Date
Application Disapproved for the following reasons:............•---........--------.....------------------.......-----•------------------•--................-•----
....................•--......-------•--------•----•----------••--•----............•..........---------•-••-•-----....-•-----•-••••--------•••-•-•---•••-
Date
Permit No.......................................................... Issued-v
Date ---.. .-•------------•----
No... _....... FEs ... ..............
_
THE COMMONWEALTH OF MASSACHUSETTS
- BOARD OF HEALTH
[Pun...............O F..I�c�rn.5.1cab le—------------------------------------------------
,�oolirtt#flan for Dispoti al 10orko Tomitrurtion Vrrmit
Application is hereby made for a Permit to Construct (vj or Repair ( ) an Individual Sewage Disposal
System at:
.... cJ.Qr.1................................................. .. ................. ... � t ...........................................
//,&/`•/ /to Lo
............ ................................ .............................•--•-•-••-
Owp9r�� � f,�@caress---•----------•--•-••-•....................
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms. .._3...........:...Expansion Attic ( ) Garbage Grinder
p�1 Other—Type of Building VW4U ,ny.:-••... No. of persons.......6................. Showers ( ) — Cafeteria ( )
Q+ Other fixtures --------------------------------------------•------------•••......------•-•-•---•--•-----••----...---•-----•--------•.....------------..........--..
W Design Flow-------I1D..............................gallons pert per day. Total daily flow..........3,�Q----------------------gall
ons.
.I r n
WSeptic Tank—Liquid capacityt5....gallons Length.10.'::& __ Width.... Diameter................ Depth4�6`.....
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
... Depth below inlet._.... Total leaching area_-a 4-.. s ft.
Seepage Pit No.-----�-------------- Diameter---=-��----;•- P �-•.-.-..-_ g � '�..-•-. q.
Z Other Distribution box (,„r) Dosing tank
�/ �97
Percolation Test Results Performed by��3 -:�t.�.�t,l�''�p�!-��ixS".��-:=--•••---•-------•-•• Date. .��,. '__ __ __________.
Test Pit No. 1._�� 2.:._:_.minutes per mch Depth of Test Pit._.-+s........ Depth to ground water �sruDu3z�AsP/�
GX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Dep P�1 MqS ater........................
-c4 ---------------•-----•••• ---•-----...............•--..............---.._........_.....•...... ------...........-•---
yak..•• ----.... ..4 .
O Descri tion o oil........ .z ra...__... .. •--RENWiCK-- yN ........................
W .......CHAPMAN....-�' ........................
........ .......•---------------
U Nature of Repairs or Alterations—Answer when applicable................................ No;27654 p
---------------------••-•
.................-...............................................................:........................................... .... ......... g • ................•...........
Agreement
The undersigned agrees to install the aforedescribed Individua Sewage Disposa ystem in accordance with
the provisions of TITL r: 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been.issiAel by h board of health.
Si ed� '
. - ---------------------•-------------------•----------•..-•-•- ..........................
Date
Application Approved BY zy .-. •F.._ 2 ....
- -. ........
Date
Application Disapproved for the following reasons:----------------------------------------•-------------------....---------•-----------.....----------.----••-----
--------------------------------------•--...----.....-----------•--------.......-------•--•-•----------------•------------------•----------------•----- ........................ ......................
Date
PermitNo......................=-.................................. Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEA
' ................OF....... .�....... ....... .........::...............s...................
CAA firs of (luutpliatta
THIS IS TO CERTIFY, That the Indivi al S � � •System constructed C ) or Repaired ( )
bY.............................................................................. •�------ -- ---------• --• - -
`1 .,,,o ( n }�] �� Installer i I . ..
.
has been installed in accordance with the provisions of LE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit N49 dated_ `:__ez.. .`_ _'_.__.._____.
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
. Inspectorf6 ------ Y---------------------
DATE......... .2 THE COMMONWEALTH OF MASSACHUSETTS
BOARD 9jF HEA T��
..-................... _2 'r
No.------.......p.,i... FEE......... .....
Permissionis hereby granted..-•------------------- ---�`---...:.-----•---•---....-------•--------•------•-•--•-----------.:......._........._..-----...:.....-..---•----• I
to Construct ( ,ore air ( In i�dtial�Sewe,i�>sposal sterr `
atNo...................f�.... .� se!r. �� . ........... ......... -
Street / �� +� �
as shown on the application for Disposal Works Construction it N ____ ___ _________ Dated-
DATE
�.
...................................................... Board of He
FORM 1255 HOBBS & WARREN. INC...PUBLISHERS p ~
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r_2•:.PEASTONE LOAM 9 FILL 12")dAx,
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r � BOX ' IIr � .° ° D PrrG 26.9
/O•MIN. 1500 I• D, ee° • 1000— GAL. v DPI 1z2.�o
GAL. a PRECAST OR e °D °I
SEPTIC t 6' I, , BLOCK ° o p
TANK I; e ° ° SEEPAGE PIT. v
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e SkYA r s 18�8j sF
f f I I • ° Sot 'N ae»
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I. 1 20' MINIMUM o
FOUNDATION I IVie" WASHED STONE Ate
I �rerfr y f&63rzrc>r�trre ; wr�r,�z
5 Wn hereon WaS AVaA*_d by an
a uaf of curve an Dec.201971 1 O' - � pane. RAYa
�r 1l rrFa�-rns wr'fh' f Zaning 4-laws lack Area r> uj1r ` 198s.F�ro��iFh 9 �9 l r ST BY : E. .• c w '' »y .
TTi�ivW nsfa6,��If7r�5$, r1 ' prOVli = 7s'Fr TOWN INSPECTOR ►"�.•�.[ ?t..�cw�y
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0 I . BACKHOE OPERATOR : P' 3-v4,•.s
t s;•,,t TEST MADE ON -
pr DANW.
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C14APIOAN wNo. M34,0
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ELEVATION SCHEDULE „ PROPOSED SITE, PLAb
I. JNV. AT FOUNDATION SE A8E 9YSYIM DIESIGN
t 2. INV. INTO SEPTIC TANK = ��✓ ✓� IN
Now
3. INV. OUT OF SEPTIC TANK =
4. INV. INTO DISTRIBUTION BOX = �3 ' SCALE: t"z 20' Jan, 19) 19"1$
-4
I C-S
5. 1 NV. OUT OF DISTRIBUTION BOX =
CAPE COD SURVEY CONSULTANTS
8.
HYANNIS, MASS.
INV INTO SEEPAGE PIT
1 _ ROUTE 132
LZ
7BOTTOM OF , PIT - 23•
_ A DIVISION BOSTON SURVEY CONSULTANTS, INC.
- 8. BOTTOM OF STONE LAYER' =