Loading...
HomeMy WebLinkAbout0286 OST.-W.BARN. RD - Health � F 7 0y- F R S'AM /I a N LOCATION /,�/ ,; �ar.�s1/��e SEWAGE # VILLAGE �5�c��/ -� ASSESSOR'S MAP & LOT )XI U t S a2I INSTALLER'S NAME & PHONE NO. SEPT?C TANK CAPACITY / v a LEACHING FACILITY:(type) 6 ' /��J� (size) NO. OF BEDROOMS `-I PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER -e DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: :x - VARIANCE GRANTED: Yes No. �� V L G L 7 (rGS l� O 4 Fmm f gt- THE COMMONWEALTH OF MASSACHUSETTS IIIJJJ BOAR® OF HEALTH ' i ©v......i................O r .1.-R ...................... Appliration for Ropooal 10orkii Tonstrnrtion ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: ................ ............ ....... ._........ ................ Location-Address � � or Lot No. ......................-... - ........ .__(., .t�_.._:F....-----•....... .............................•-•--...••--------------.........------------•-------_.....__-..----- caner Address W ,). 1� : -: Installer Address a Type of Building Size Lot_l t_��_____It t Dwelling—No. of Bedrooms_______________________________________Expansion Attic ( � Garbage Grinder ] N Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ............................ . w Design Flow.....�?�___________________________________gallons per person per day. Total daily'flow_.__ 3_ ?.........................gallons l W Se_ptic Tank—Li uid ca acit .) gallons Len theme..._ Width_ Q Diameter._.—______.. Depth �-�-�---- x Disposal Trench—No..................... Width.................... Total Length.....................Total leaching area.........:..........sq. ft. Seepage Pit No........I--------- Diameter._.____._e_...... Depth below inlet.... a_.__..__.... Total leaching are ...sq. ft. Z Other Distribution box Y-95 Dosin tank (( ) Percolation Test Results Performed by� ! . ..4 Date �Z1 ------- Test Pit No. 1._4Z_....minutes per inch Depth of Test Pit....M......... Depth to ground water T. _iteli�Zi Gr, Test Pit No. 2...ZZ-___minutes per inch Depth of Test Pit....1Z=........ Depth to ground watern, f3.�C�UxaF a •-•------• ----------- • - ---------- -----------•---•---------------•-•------- _ Description of Soil...4)••""-Z- ... .l- ^� ... ------- x : -------------------------------------------- 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 system in operation until a Certificate of Compli nce has been issued by the board of health. g l ned•- w ~ ' Date - Application Approved By...................... `..•• ----- - • -�•-•-•--•--- ........J..............................•" Date Application Disapproved for the f ollo - g reasons:------•--------•-----•------•--•------------------------------••----------..................................... ...................•-----•--•----•------....-•---•...----•--•-----------------•••••--------•---..._.......-------------•-•••••-••----•-••--•-••-•---------------•-------•-••----••---•--•-••---------_--- Date PermitNo.......... ........ . .. ................... Issued:....................................................... Date ,i- No.......:.". FEic..........................._ THE COMMONWEALTH OF MASSACHUSETTS BOARD-- HEALTH .........................0 ­1F.......................................................................................... Applirtation for Disposal Warkii Tutu rnrunn Frrutit Application is hereby made for a Permit to Construct (11<4 or Repair ( ) an Individual Sewage Disposal System at: r' _ _ floV 6 A .Leca�igli-Addr,�s ��N�„� or Lot•No. ........... ........_.........'_l!..,.....`......... �rj` £.... 1 W R�`A W 0 V �!�'zet� �A T Address •----••••. ....... ........ Installer Address UType of Building 13 Size Lot__________________________ �-, Dwelling—No. of Bedrooms............................................Expansion Attic (V\P Garbage Grinde7 aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) dOthe-fixtures ----------------•-------------------•-•---------------.•..••------------------------------------- W Design Flow____.: __________________�� _gallons per perso pe day: Total dail iflow..__:�.�_. .................. no WSeptic Tank—Liquid capacity_ .___.____gallons Length`:�.'=a.___. Width . _ ... Diameter________________ Depth______................ x Disposal Trench—N,?_____________________ -JVidth... ___._____.____ Total Length.................... Total leaching area___._ r.sq. ft. Seepage Pit No___________ ____ Diamete.r.__________..___._._ De t below inlet__.____________..._ Total leaching area..................sq. ft. Z Other Distribution box ( Dosi nk (�; --�- r-� c> Percolation Test Results_ Performed by. `1•--•---•-�-- --- Date ---------••--- -" --••.. Test Pit No. 1._-4 `=-____minutes per inch Depth of Test Pit._.__r. ________ Depth to ground water_ `t'3`_1r''t x"f"``� Z`� 44 Test Pit No. 2....12-___minutes per inch Depth of Test Pit____________________ Depth to ground water........................ ` � .-...f'.t:.. :� � .S-.. -� ` crptono � .. __::_ ._._ ' . � ._. _c_ U --- ..�-�-�---•- �� ------- �-'J- �.---.._ ----��.� . W UNature of Repairs or Alterations—Answer when applicable............................................................................................... ...............................................................!............................................................................................•--••-••• ........_......................... Agreement: The undersigned agrees to ins-all the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the Sate Sanitary Code— The undersigned further agrees not to place the system i operation until a Certificate of Comp • ce has been issued.by the board of health. /—� me ApplicationApproved By........................... --•-:--•••••••---•-----•---_...------....-------•-•------..._•--•- / Date Application Disapproved for the following easons:................................................................................................................ 6 t - 5.3 S -•-•.......---•------------•-----------------------••--•-•-------•---......------._.......-•---..__.._....__....._._..--••----------------------------------------------------------------------....-•--- Date PermitNo......................................................... Issued....................................................... Date — THE COMMONWEALTH OF MASSACHUSETTS BOARD e6P-H H ..........................................OF........................................I............................................ Orrtifiratr of f amplianrr THIS IS TO CER F Y,To; the Indodu�VTfq Disposal System constructed ( ) or Repaired ( ) by•••--•••------••-•-------••--- -•---11_________ _______________••-•-•----•------------------- ----•----_--••- at ----•-----------------------------------------------------•-•------------•---------=---...-•--••------------.....-------•-••••••- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described 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-------- t ........................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD 6F-HOM441 . ..........................................OF..................................................................................... Sc� �-- NO......................... FEE........................ Disposal Ngh.5 T incW ,,,,t ,ff- Tit Permissionis hereby granted--•- -----------------•.._....__-_.....--- �--------------•••-.----•-----.................................................. - to Construct ( ) W Rg��i ( ) Individual oge Disposal }snVj, Q IV p� M f atNo..............................----1--��----•--..----•\ -- -----•-----•--------•-•-•----•--- J r --••--•-.. Street as shown on the application for Disposal Works Construction Permit No................ __ ated .......... ___........................ ............................................. --- •----•---••-•---•._...___...._____..._...__......__.. r B r of Health DATE................................................................................. FORM 1255 HOBBS & WARREN. INC., PUBLISHERS ` 1 DES IC N DP�TI-\ T /oF 2 SINCE FAM1 -1� - 3 BEDIZ..00Pj --- + No E���'QAC-E G►2tN DCCZ. ..._._ DA1t..Y. FLov./ 3 110 x 3 33o G.P. 1J. SEPTIC TANK. L .4/7,qcyc/b USE 1 000 GAL. TAK :. 0v&PosAf_ PIT- vSE 03 1000 GAL. .�....__.. - StDCwALL ARLEA So S. F: 1So s.F. 2 .S 375' C.P. O. BolroM . . AV-CA _ 5o S.F. 54 5.5. x 1, o t slo ToTA L t)ESIGQ 4Z.T G, P. 0. TTTAU t-AICY F-LoW = 330 Cam-. P. D. PMCOLAT aN3 RATS t . I"iN 2 1y#ti1 .o21lESS -i4t1 OF Mgss . VdILC AM PETER N Y E `` SULLIVAfV I � ,P Mo. 19334 "" No. 29133 ,! Mon- o iv S FsT SS/ON. Ey`\�i P6ASt��D orL) S c1 d3 _ `l t.�/,r(� ,••w VAS"�~ � �/ v' C', TEsr <�o t�E P- 49 Z �'I ►`l Goh1lA►� — 13a,�-t-�'�tL��/l��C:. L�i✓G v.o Fr. 3 SO •Z -t Aw- t�s� oisr, aox SaNa � •� yg,� S.E'.�r�'G ug'� ''' P.7- �Grcavt� �� . �f 3�g*W1 4SHC-DI..-, uean �� C•:_,,,�l��"tom.42- LOC,�T/O.S� J\1A,eS 7-C)Aj7A a 1v1, ids PKO�t LC i. F,��,: . . .::. 0 5 t�3 ... R ill. .Q /'GE.2r/iCY Tf/f1T'•T•S'�' I'��P � �: ;. l"�L�_ F L9,v D f;4, 1/r�:�E�r1r�•� I y i4N0 S B/JG,� B,4xr2 e IT //rE/lvc. .2�4v/,�E'Hl�NrS o� 7y� ,2,EG/.STL�.Pt1J.L.QNo.S!/,eri�ryo,P,,S 7'OWit/ dFl��j,e^!S7,q/3L�'" .Qiv17 /S it/OT C�sT�.eY/LG.c' d• iyl,�.� LOc.4r�.v y1I/THIiS/ 77-45rW /1A2//a- V/ljZ—/7 fsj C I�J 7//ls Wit.�,v /s �0 13 � T 44 O 4it/.Qit/ s�DYNf�E.eE4N.S.�v��!/G�yaT-Q,� USE'. 5M!EFET z o Z 04 P74 2S' oju nVol\ J L-OT S �r9.3 I 11 ,3i Ac7 to T I > N n Col. 0.7 &Z So.o 60 � Q '►f' a� � Sl•C � - 5'9� 4°�, 5 y jw OF o�'•• c4 icy � � • /, PETER ��, SULLIVAN k/F$� .L No. 29733 o SS�ONa AI.0 I' 00 DE S IC N DPT/-\ SING-LE FAMtt -- 3 BCOtZ.00P'j No ErAZ-'bAGE Cr9wJDCIZ. CAA I L.Y. FLavJ Ito Y, 3 " 33o G.P. t0. nC. TANK. = 33o x ISolo ` 499 G.P• D. ;% ,��cNc�� uSE l o0o GAI.: TAKW.: S�7- 0►SPoSAL PST vSC oco CTAL. 510EwALL AREA z So S. F I So S,F. 2 .S 3 7S G-.P. O. Br�1ToM . . A9-EA = $o S.F. o z S'n G..P. D. TOTAL OESIG& 4ZS' Cam'. P. O. TTAL tAILY FLoW = SS G-. P. D. FERC0LA-TjoN R.ATP., 1"itt Z tl#A1 .02LESS ;;F Edc;�41�✓ H OF /y9ssq VrILLIAM ° PETER C. j� N Y E �%"; SULLIVAN No. 19334 .'' No. 29733 3 /Doti- : a- &-VA'T a/v s 4 C`C ST�`i � •' � STD +` SU n^`i�.� FSS�ON Eti�\`, F�f�S(_'D AS 5,J I't C-79 49 Z(o :. �JG I I`-t Co rtl l_o� •- �a,mot-�-tZ.��Jl'�, i , 1. •► S/,o S'z 5o k. ( f�., p�sT, ��Ys/Ep�� /O O O .• /.i/1/. L��p Sa�•.ra tC,A A 7- taS�7' •• 3I`/ 7o J�`,' �f8.zg G',E.2T/F/EO PGOT pG:4N g► ��.4i, • W�4SHCD . uAE-An �'�---c� /'(..—�JC..41 4oeldnaN 44k-,�T RJ S H, w►c SGGLE� PRO F+ LG ,dl_c v r...;. oT SCALCsE &4,VS J" / k, : 1<HT /ou b IW/i2oPo i:;- F, ,e 14 f=��. 7 Y 9gZl AiS/D.S�'TY//�oi= ,2E4U/,�E'k1�NrS o� Tiy� ,2,EGisr�.ec'I o.t.Qiv lieYEYo,�S ToWic� of�<},eNSTA/3G�' ssv� /S�vor- Gocdr�,a /YA 2//4- V1 C 0A)�C lZ 17 fs� C 7' lW P�.v -�� T 13.41E0 GN•QiS//rY.ST,Q- ------------------ -�/.yEiyr-.svevc-Yftcip ?-//�o�FS��' sh�K/�.�E.2E4/V.S.4/4L/G j>�pTQ,L USE �s o lu I �. LGT S Ac . so 19.7 to 6 _ N v � N o , L� roo•o 60 Ro � „i b�•6 sl•� � vy r OF G PETER SULLIVAN No. 29733 ° ONA 5CA1.� Iq po'