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HomeMy WebLinkAbout0700 ROUTE 149 - Health J-Yl Gt rS 7 0� S YI'T 1, L S I / � / -' ab< yob / LOCATION o SEW, AGE PERMIT NO. t/ Too cal of T Rowz> VILLAGE -AU-/I , I N S T A LLER'S NAME j ADDRESS- 9 UILDE R OR OWNER © --��- ✓off,h 14u, Y DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 3cs - � � �, �s_- ��., 4 ti� �� . �!�` � 3� 3 ,. �� � lguX (�i� No.. . Fu ..... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...----- ..... .....................OF...................................... 'Allp iration for Eliiprrsa1 Works Tonstrnrtinn Prrutit Application is hereby made for a Permit to Construct (✓`) or Repair ( ) an. Individual Sewage Disposal System at: / J,o r a 2fe /49 f C�rrr�r R,�� MA�3�ws �►lt�s ................----------...................---�,- . � ----....--------------------.............---------------•-----------......-•---•...............--- Location-Address or Lot No. ......................_.....70-k"V f%tl.... .......................................... ..........--..............................................................................._..... Owner Address 14 ........................... .t........_. .._.. ----- ...^---. ----------------------------------------------....-...... ......... -........ --.------ ......... ._._. Installer Address Type of Building Size Lot.. _ 4_4a -----Sq. feet U�+ Dwelling—No. of Bedrooms....._ Expansion Attic (No) Garbage Grinder (roo ) Other—T e of Building No. of persons............................ Showers a YP g ---------------------------• P ( ) '— Cafeteria ( ) 04 Other fixtures ----------------•-------------------•------••--------------------------•----------------•-----------------------== ---------- wDesign Flow........... .........................gallons per person per day. Total daily flow......?2O...........................gallons. WSeptic Tank—Liquid capacitylkob....gallons Length..... ........ Width...'l.......... Diameter................ Depth..:............. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No---------/.......... Diameter----G............ Depth below inlet...6...f-'t....... Total leaching area.,,2.6.Z......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by...6?�M?Ab..�'caEY...... a ;---------• --. Date Test Pit No. LL..'2......minutes per inch Depth of Test Pit..Z2............ Depth to ground water------------------------ GX, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------.................. a ---------------------------------------------------•--......------........------•-•--•......._------......................................................... O Description of Soil....Co.&V;rr-..�N_ ...-....Mcn22ltlM-..:Tu.. APSE_..S�!d!D-.........W' Q.-wA�e�R --- 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 TITLL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance hasibeen issued y the board of health. Application Approved By--------- --------- ..��`%........... .......... � 7----Date Application Disapproved for the following reasons----------------•---------------------------------------•-----------------------------------••--------.....------ ... .... ....................•----•-•-•-••--------••---•-----•-------------------------------------------------------------------...- -----••••--- Date PermitNo......................................................... Issued....................................................... �[ - -- - -- ---- - Date -� No Fmc THE COMMONWEALTH OF MASSACHUSETTS '. BOARD OF HEALTH . --...... --- .....OF...................................... ApplirFati.on for Disposal Workii Tons rnrtion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................__.............................................................................. .........-•••-••••-••-----•---•-•---------------•-•---•--•--------..........-•---...............•• Location-Address or Lot No. ......................— ....................... ..........-- Owner Address W Installer Address Type of Building Size Lot............................Sq. feet ,. Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aa Other—T e of Building No. of persons............................ Showers YP g --------------------------•- P ( ) — Cafeteria ( ) Otherfixtures ...................................................... ----------------------- W Design Flow............................................gallons per person per day. Total daily flow................................._..........gallons. WSeptic Tank—Liquid capacity............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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ a: Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... �14 Test Pit No. 2................minutes per inch Depth of Test Pit..............._.... Depth to ground water........................ 9 -----------------------------------------------.............................................................................................................. 0 Description of Soil........................................................................................................................................................................ x V -•--••••-•••-•-•••••--•---••••-•••-•-••--...--•-•--•-•-•••••-•-------•-------•----••-----------•••-•-•••••-----------••--••--•••-•----•-•-••-----••-••--••-•--•-•-•••-•.......................••--•..••. � --...................................................................................................................................................................................................... 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 Compliance has been issued by the board of health. �.---.-----`=`= S,igne& -...___.._. .. -�Application Approved BY- A Z Date Application Disapproved for the following reasons:------•--••-•.....--••-•••-•-•-••••••--•••-••--••-•--••------•---••-••---•-••---•----•-----••--••••............. --------------------------------------------------------------------------•-•---•----------------------------------------------------------............................................................ Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... 10.1rdifiratr of TnntpliFatta TIIO'�ETlFate�Lt i dual Sewage Disposal System constructed ( ) or Repaired ( ) � � - ...- � -Installer has been installed in accordance with the provisions of SIT F 5 0 .11e State Sanitary o s `cribed in the w j 11 �rrl.- `.application for Disposal Works Construction Permit No......................................... dated_-_..___.__.._._.._.__. 5,___._.._..___.___.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............. _= .. ........................................... Inspector........-- --•-•• •.... ........................ THE COMMONWEALTH OF MASSACHUSETTS BOARD -OF HEALTH w.. No......................... FEE...: ........... t rn ttlSpAgons#r tan rrnti# Permission is hereby granted......._...:�."~-`>...-_-:........_._ ._ `- Yr-•-------•-------•-------------•----........--------....-------•--•---•-•--- to Construct.( . prRepair ( n dndivirlu Sewa a Disposal System at No........... r��- �•-•-•-C '. C % �. - -------------------------•------•------.-••••-------------------•----•--------••--••••--•••--------•---•••......---•-•--....._......... Street 7:5;4 J� C / /Q as shown on the application for Disposal Works Construction Per' it N -_ / Darted.---_--<_ ?I--- :................ s..R� .....`........... •.C_�`" .e=......A't..�•�....,�,,..•r Board of Health DATE--------- r ............................................. FORM 1255 A. M. SULKIN, INC., BOSTON 1' Zoi✓o� (zF .92cl / , y3,�0 56 F=< O V / �' ROBERT /Sjj T� X BRllCE DRED 30 Fit- c 9t.f !9 oe- _� suti' ' Z 96.61, /VALiq,v . ! Ok �, 1 3. yy;9 A K wax ��* � , ` 3i-_• fIp s -7�.,,,, c✓Rr� s� 1 ,w /2 ' Z 7 4, �. .� PI11 L / �X/571�G Komar.- 0 T /.7 . leas �..,.• �4:�i 9ERG < -�. ti �X i 7,,b i r� /�C►t. C,_t r r '►� NHL 1 / LEGEND EXISTING SPOT ELEVATION OAO CERTIFIED PLOT PLAN EXISTING. CONTOUR --- 0 --- FINISHED SPOT ELEVATION* (� ,CoT ,Z o7 T Z6,14 FINISHED CONTOUR 0 M,SF STD f !ILLS NOTE: The location of any: existing, undergi i_ ound sewerage, IN wells, or other utilities shown on t} is plan is approx- imate only as determined from records and/or verbal SAl g kI S�TA-91 information. The contractor is responsible for the verification of the existing locations in the field. SCALE, / �r ya DATE 1/ ..5 �CDREDGE ENGINEERING CO. IN s°h,^`yvN CLIENT._ Z 1 CERTIFY THAT THE PROPOSED ' oo BUILDING SHOWN ON THIS PLAN Eels ERE REGISTERED JOB N0.�— CIVIL LAND CONFORMS TO THE ZONINO LAWS N0 N ER R DR.BY, ' OF BARNSTABL MASS 712 MAIN STREET CH- BYE � HYANNtS, MASS. SHEET� OF DATE REG. LAND SURVEYOR NOTE : /F , H.JW T/,/E SEPT/C TANK OR LE,4CH/iVG P/T ARE MORE° TNA/V /2"OPLOri ► /D pr. MIN r�tAOE, 24'O/AM E7ER C0NC^F7'1E COP&. SHAL L B.F B R0lJ6NT TO 4RA O.F. � AF/V r7R'A ELt� CONL•�gET�v 'q'Pi/C PIPL t/E.4VY CAS7-/RO/Y CO•/CaR SHALL B.E 41 (��� COVERS MIN. P/TCN /F/N OR/VEK/A y it v. 2 14/N. COIVC,eE TE d .•IOE COVER A i _ CLEAN SANO �" •. • . . BACK/=/GL s. LIQUID LEVEL .>•: / q D�17. I .• 2•LAYER ScNm uLi 40 I/b• 3/e /+'lI1V.P/TGN D/ST, d WASHED STtMNE %4•Pt/t -r. SEPTIC TAAIX BOX • i i e • • • • • r .• - • r 1 1 •EFf°ECT/VC • i , . �° ° r • • DEPTl1 • • ' e . jV.4SJdED STO/YE .�fe 1 1 • • • • • • 1 0 �f7( �r•'� i ago• r � � • • • • • 1 D ••� PREU45 T SEE.PAG£ 7g.sxGo - 7S f�/7 0R EQlJ/V , I/V!/eRT C`LEYAT/ONS / ► ° •. • • • 1 e /NYERT AT 4ffl114D1N6 98.5 Fr FT. C CSEE 7;-9QUL..ATJON, J,V4E7 SEPTIC 'T.4..VK �1g,3 .FT•, OU7►4ET SEPTIC TANK ;/ FT. /NLET D1STR/9!?/ON BOX �•9 SECT/ON OF GROuNo N.G4TER TABLE oaneTDISTR/BL/T/ON BOX q7,7 . SEWAGE 0/SPO�SA t SYSTEM INLET L.EACAIIMG I�/T 97 S_f7. -rA1 JLATlGN '. LEACHING F'/T olMEnrs/cN �► 3.S l�•7: SC.A L.E Y-0~ s O DES/6/V CRITERIA VIMAWB/ON 8�—�T• NUMBER OF BEDROOMS 2- D/MelVS/ON G FT. Gs+Re,AGE DISPO5AJ- VN1 - SO/L. LOG_ SO/1- 7 EST TOTAL EyT/M�'TEL> FLO/•t/ Z� G.4L.10A-r SOIL TEST ) SOIL. T•-•ST02 NUM$.ER AF ZOACNINZ PITS I f"ELe`Y. 98•Z ELL�Y. ,DATE OP SOIL TEST S/OaF LG°ACHJNG PER P/T 189-s- SSYt PT. b_( �� DLoom /RESULTS h/ITNESSED dY '�D OP le61-LU 90TTOM 4r.ACN/NG PER P/T SO. FT. �5UfwL- AE'RCOLAWON RATO Af/ ^7.' VVINCH TOTAL lEACH/NG AREA 2�� SQ. FT. ` /°1FXCOLAT/ON RATE/�2 — MlN.11NCH RESERVELEACNIN6AREA 7-G-)_SQ. 3 23 7 A- J"Vy g 0�R S y,`tP�1N OF�yQsle�� ,�'�,�- �..., e .�.. /Z•E/r�J�� 1Y9, 1n/.!,¢.sTd e.s /�.��s, yYrq; ,;/3 •�::.r. o :,.L M EDP dM J V; R08ERT ��` ; g ,PNILI 8'fZ 7u GUAnx 'g BRUCE � ELNB , SAS ELORED �� 366 0/. - I�A.A>A ,099, ,�I,A�,�rl*vm/?/A"CA�/A�&. ; F EZ.BG.x 742�AtAlN B7� /{yAit!/1I/3, MASS ate' N ` /EfO4�dUND J V,4reAf !�/VCOIINTL�7�E0 FeAlAOFNV'!lv ..r Q0 suR' '"..Y+ f„3_ t . _ AA!),- es*-b