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L0 CAT INN SEWAGE PERMIT NO.
L o d Lc,,, S�� 7�
� villACE
I N S T A LLER'S NAME ADDRESS
Vr,. A ; c\fie
B U I L D E R OR OWNER
o w S
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
'I
\ i CC cot-
AN 0�
1�
No.... . ....
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
......'�'^"`.{ ..............OF.......:... 4 ..E'STi4ai.
.......
Appliratiun.for 3 Vviiat Wor.kii Tow5trttrtion VarA t
Application is hereby made for a Permit to Construct Pj or Repair ( ) an Individual Sewage Disposal
System at:
.......................................... .
f� Location.Address or Lot NF t
.... _...�...r-. .�:r.....................--.........---- �, ,� ' 'J...� I.. -- - ,fr/...!.1. ...
t Owner d�tess-
w p1�t ....-- ---•--- .. Q?T./� sr.............................................
...
Installer Address _
Type of Building Size Lot..........!r!.......Sq. feet
Dwelling—No. of Bedrooms.._.__ !y ........................Expansion Attic ( ) Garbage Grinder ( )
'4 Other—T e of Building No. of persons............................ Showers — Cafeteria
04 Other fixtures ...................................................=••�...........................................................
WW Design Flow.............. ..... per person per day. Total daii flow...........33�..... ............gAlons.
WSeptic Tank—Liquid capacityla�o..gallons Length..%;5.... WidthAt, ...'Diameter................ Depth4.9
x Disposal Trench—No..................... Width.................... Total Length.....................Total leaching area.....................sq. ft.
3 Seepage Pit No..o'-�.5 .... Diameter....C?.-S�tiDepth below inlet.__�v-.��Total leaching area... ...A_ -sq. ft.-
.
Z Other Distribution box Gej Dosing tank
`" Percolation Test Results Performed by.......::Z-_._:_±`'!!4! '�3'` �_ .._� Date.A?/4/.&.1 ................
1.4 Test Pit..No. 1.. z--...minutes per inch Depth of Test Pit..:!.5...�..:.. Depth to ground water..��!... ..
f= Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
-
...........•••-•-•-_....._....•---•.....••-•.............................................._ ...
----........ ............._...................................
0 •Description of Soil......c?U..".z-fir._., �ec.r,!.... ..�4 .�...I �••. 4......� ' _...lGc ..':-r?....d:`....r*_`...,.
:. ...................Sun ..... ................
U --- .__....._.
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 LITL—_ 5 of the State Sanitary Code— The dersigned further agrees not to place the system in
operation until a Certificate of Compliance has b i edb of health. }'
Signe .............•---..............--•...:.............. ........to
ApplicationApproved By................... • -• ----•-T • . --- --• ......................... .......... A—— .........
Application Disapproved for the follo ng reasons:.................................................................................................................
....................................................••-•--------...........................................------....................--•---------......................•........... .............
Date .
Permit No. E--'--.. sa................... Issued............._.._ -.'
....---•------• ..............
- tc
No--------- FE13............ ..........
` THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Applirtttiun for Uiupuuttl Vorkg Tonotrartion rrrmit
Application is hereby made for a Permit to Construct O or Repair ( ) an Individual Sewage Disposal
System at:
L A,.,,,f Gs /-/W A_J'Tc_J 1-4 i G.L- �it., � �Jr�IZ-10.,.t
................__....._.._............................---...-••-•......................•..... ................•--...--•---.......---•-••-•••--•..........•••...........••.......................
„��— Location.Address or Lot No.
c..�... ._ �. /_.. '................•.•..........----..... /. 1 '�--�-•1-._.).3- ......_ 1.f,
Owner / Zess
►wa I. ..J.4C:. �c..J.... � ��.C..a. .!_•.__._..al'_. ../..�:�...................................................
M / Installer Address
Type of Building Size Lot.....:.:..................Sq. feet
U Dwelling—No. of Bedrooms.......................... =•...............Expansion Attic ( ) Garbage Grinder ( )
p,, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Q ....at Other fixtures ................................................
......
W Design Flow.............. ` ..................gallons per person per day. Total daily flow.......... ................................gallons. ,
P q P Y g gt Width;!E::.`r_..... Diameter................ Depth�:.4=:F. - .
W Septic Tank=Liquid ca acit !�'��_. allons� Len h �.:.`a.....
x Disposal Trench—No. ............. ...... Width.................... Total Length.................... Total leaching area....................sq. ft.
3 Seepage Pit No.. �-[ .....Diameter.::�.��.�'Depth below inlet...��. r Total leaching area_._E' �!....!sq. ft.
Z Other Distribution box O Dosing tank ( ) �-L ► �r�
'"' Percolation Test Results Performed by.......-�_..... -A,.. =T�g'`/ :.3.7 . .... Date, -��_�y It.............
Test Pit No. 1.. : -...minutes per inch Depth of Test Pit...?................ Depth to ground water..
° Lt. Test-Pit No. 2......$........minutes per inch/ Depth of Test Pit..................! Depth to ground water....._......_....
.......................................................... ............. .................................................................
O
Description of Soil-•-•-•�'---`=�=�k-----...1��,w�..� �� -'---�-..._s---Z 4 - !�x.�• I C�•.r,-----..��•`.�
V _..- ----'--`---- 4r—p.vc� r e ,P S h � C h�7 U .. ..............a........t......
W . t
x.. 4;,,W..............•------._............_._. :_..... ................... --- ... ................
V Nature of Repairs or Alterations-Answer when applicable.................................................................................................
a ....... ....-•----.••-• •-••••-••..........•••••--•--•••••-•-•••...................•-••--••••----------••-••-•-•-••••••-•----•••----•••••.........................--••••...... ..........
Agreement:
The undersigned-agrees to install the aforedescribed Individual Sewage:Disosal System in accordance with
the provisions of AITLL 5 of the State Sanitary Code— The dersigned further agrees not to place the system in
operation until a Certificate of Compliance has b i ed e d of health:
Signe ----•---•- °.................................. .+
Date
Application Approved By.. •••- '�_...._ ...�,J�, �� \-------••- .1
f.i ( 1 C
,._ .. ..,...._....
D�te -�
Application Disapproved for the following reasons:..............
---•.._....._...•---••--•••......•--•--••-••---•...--•••-••--.._..•-•••-•..................••----•-••........................••••---••••---•-•••-••-•.........._.................••••..............._....
Date
Permit No...... �.�? Issued.......................................................
-Date
.................. .«. . .....,w.w�_ .... z................ .........
i
(� THE COMMONWEALTH OF MASSACHUSETTS
f BOARD ' F HEALTH
OF.... r � .. ....... ...2...................
'Mir f int of Toutplitturr
• THI S TO URTIFY, That the Inuividual Sewage Disposal System constructed ( CTor Repaired ( )
------------------------------------------,.. — 1 j Installer //
at... t,� ��f ,� ``-�s ! ' r .t�'�.... �L�'t. eT� % / �... .
». has been installed in accordance with the provisions of TIT LP, 5 of The State Sanitary Code as described in the
•
t application for Disposal Works Construction Permit N �o.._.. -+:__. .A......... dated_ ..._-�`._ik.J. �..................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE C STRUED AS A GUARANTEE THAT THE
SYSTEM WIL FU TION SATISFACTORY.
Inspector DATE...... ............................................ i- ......
. --...•--�..... ................... '............ ................ __ . .. .. ._.__...._. ....._.......,.....
E THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
I� T I N TA L SAT,o
or,
oF.... 1:. 1 ......... ................. 5 0—
FEE... .................
aispouttt arks Tonstrudion ermit
Permission is her&by granted...........!.. �-::f5 ,::. �'_....�_..�._...� t
to Constat
r ct R ai ( ) Individ 1 sew a a Disposal System
•- •-------•- -
1 T Street
_�. -.4............
as show Works on the application for Disposal orks Construction Permit Dated-------_..o._�-�_"_� .__.__ �_. ....................
t �•�,
Board kcalill
DATE......-•-••-VC. I. g'--- -------------•-------------------.........
mot. �..- ,-
f
SECTION - SEWAGE
I •
t t -SEPTIC TANK- 3 -"D"BOX - `3 -LEACH— �
TOP OF FDN
(MSL)s
-"2"OF T0 lh"
WASHED STONE `
(-�f�l�
OUT• IN-
OUT
^ Q 1 1 OOO_
__ G • IN•
I4�•�C3 SEPTIC
Lem TANK 1 48.Zj
ELEV. ELEV.ELEV. ELEV. 41
(1 CO :_e 1
COr%Ae'r rec+i./. 140. I V•(7(Cl / A . .
ELEV. ELEV.
/�L�
Rye
1 CO I ,��""�O/ / f � � u�'� J•- �-� 1 G�C�
14FZ.
°t
OF V4"
WASHED STONE p `A
-710
TEST HOLE LOG �- �,� �leu: ►a� :o / �i
TEST BYR.�trbOrfk �. Conla.n 8 ,cz,
WITNESS {-
TEST DATE 4l �� DESIGN z BEDROOM HOUSE - c�T 4'�
1
T.N: • 1 T.H. # 2 67A 7 An o
ELEV. ISO ELEV. NO
CDC , L�.�14 8, PERC RATE 2" MIN/IN. DISPOSER DISPOSER i'
/
FLOW RATE 2-Z 0 (GAL./DRY)
SEPTIC TANK Zzo (►'1= ado /, Z�5
REQ'DSEPTIC TANK SIZE 1
LEACH FACI LITY
SIDE WALL tGro 1 SO. 2 3-
) (2,a a l-7.O G/D.
a �2 Ala 1 tO
C BOTTOM k�/v� = So • 3 ►�t.� 5n . 3 G/D. = '•��-
S S� TOTAL ZoI ISF 47-1 3 rj•!r_> } i�(�-. 1 8.Z4XIsD 3�I
USE: LEACHING
WATER ENCOUNTERED
NOTES (UNLESS OTHERWISE NOTED)
1.DATUM(MSU 4 TAKEN FROM J` '�3AI.rj�.nJ�S N QUADRANGLE MAP
2.'MUNICIPAL WATER 1 S aVAILABLE '��' G SUS i c2 b�iZ S�eC_i��
3.PIPE PITCH:l4"PER FOOT 7C;07
4.DESIGN LOADING FOR ALL PRECAST UNITS:AASHO- -441� L�
3.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES:(2)FT. �tH OF _ _
6:PIPE JOINTS SHALL BE MADE WATERTIGHT1-�Cc�--4Y
7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. AR 1E H. �.
STATE ENVIRONMENTAL CODE TITLES SITE PLAN
�.IOT �� t3�D Pam, �SZo�=-2.�K L•��- �Ta.�.�,`.v `� ( � LOCUS: 1-o T 48 AI-A E
A-A'Of
ENGINEER
`�roRAIE, I,/ /ENE cy� REF:
,dOW0 Cope 0J7.v1 IeefIII� r 4N, PREPARED FOR:CIVIL ENGINEERS
ENGINEERS i s4f o
BOARD OF HEALTH LAND SURVEYORS R RVEYOR
CONTOURS (EXISTING)------------- APPROVED DATE MA.' Yssiw�,,>l�li• \ ��, / SCALE (1_
(PROPOSED)-o-O-'O-O- -
DATE -
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