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HomeMy WebLinkAbout0078 SAINT ANTON'S WAY - Health W cool of ct,t'��t5�15 'I i L 0 C ATt0H S £ tryACL PERM- 17 NO 070 c2 F YZ--- _._ 4 i J 1 AL N A M E ADDRESS �g UILDE R OR 0vy" ER e DATE CQA4PLiANCE ISSUED 1-f/ , �ts? 01 h j ASSESSORS MAP NO: p ® f 3 > PARCEL NO.: 0 1 �$..........................._ THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEAUT .,oO.07.--- ....OF.... .. / 5....C[ ------------------------ Appliration for DioVooal Works Tontrurtion Prrutit Application is hereby made for a Permit to Construct W�'or Repair ( ) an Individual Sewage Disposal SySt�,�8t e.j .........i � Location- j� --.... a--- � �vr . wne� Address ----------------------- --------------- ..... ........._.. Installer Address Type of Building Size Lot.a 17.V...Sq. feet U Dwelling—No. of Bedrooms...........�---.--•:-_-----•-._------•Expansion Attic Garbage Grinder fte) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures --------------------------------------------------------------•-----------------------------------------------------'%, ............................ Design Flow.............ZS ...............gallons per person per day. Total daily flow......... _. . ;. . .,r. ..gallons. w a. WSeptic Tank—Liquid capacity�.QP!Zgallons Length______________ Width................ Diameter---------------- Depths............... 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 to Z / G^ �.jrt _. . �._ C. Percolation Test Results � Performed by.___:._���!' . .��__. __���.��'!��r•I.n ate...._____._ 04 Test Pit No. 1__ .._--minutes per inch Depth of Tzsst Pit..._. _ ...e__ Depth u gground water.._. ►.. r A/ fs, Test Pit No. k6!,: ..minutes per inch Depth of Test Pit..l-.............. Depth to ground water__...................... �+ •---•-•.. ••-•------ - -- -------- p Description of oat . O..a!'t .. s 4. fir- -----------------------------•--••-.. ........ ............................. - ............).......... 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 Compliance has been issued by the rd of heal Signed••-• -•_.......•.-•--- • .. ... ....... ...............•••----•-•--- ...... ._ D e Application Approved BY ................. ........... '� D to Application Disapproved for the following reason .............................................................................................................. ...................................•--•--•--•-----•-•---•---•-•--•---------------•---........................•-•---.......------.....------...-•-...--•-•---•-••--•-•-••• ------ ......------•--- Date PermitNo......................................................... Issued........................................................ Date No....................... Fimic.......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD AF HEA7� 4 T AV &,.e?........OF..... .. .....e��S. '�- 6 . f ..................................... Appliration for Btspmal Works (foustrurtion ramit Application is hereby made for a Permit to Construct (Ae�or Repair an Individual Sewage Disposal Syster3,at:./ .. ................ ................. 'Location AAress C> , N . .......................... ............!a..................................................... ...................... Address ................. ....................................... •.............. S C_ .................... ....................... . ............... . ...... Installer Address Type of Building Size Lot..�p It -7 7 *Y" ................. ...Sq. feet Garbage Grinder (tg* Dwelling—No. of Bedrooms.....•....:. ............................Expansion Attic (414 Other—Type of Building ............................ No. of persons._.__.___._.._...._......... Showers Cafeteria Otherfixtures .......................................................................... ........................... < �y­tt-- -------------------------------- S i '2� Design Flow.............. ...............gallons per person per day. Total daily flow___....... .................gallons. 9 Septic Tank—Liquid capacity 5?.I;kallons Length................ Width................ Diameten-.............. Depth................ W Yp Disposal Trench—No. ..................... Width.............__._... Total Length.................... Total leaching area------_------------sq. f t. Seepage Pit No..................... Diameter.__................. Depth below inlet.................._. Total leaching area..................s ft. Z Other Distribution box Dosing to Vate_.. ....Percolation Test Results Performed by........................ ....... .. .. . st Test Pit No. 1.,��o.. ......minutesperinch Depth of Pit Depth tdground water...11610,�e 44 Test Pit No. 27h,!!f�sA..minutes per inch Depth of Test Pit---�.. ......... Depth to ground water....................... ...... ....................... ...........;. r........................................................................... 0 Description of Soil ---------- ................................................................................. --------------------------------------- ................................................................................................................................................ ....................................................................................................................................................................................................... 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'21 T IZ4 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued by the rd of hea Signed i�............ ..................... .... .--- k* ....... I............. D t ng.' 7 Application Approved By........................... ;��4A 2.......... ..VU.....( ..................... .....q Date Application Disapproved for the following reasons)....................................................................................... . /............... ....................................................................................................................................................................................................... Date PermitNo....................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAL71-1 ........ ..............OF........ ........................... ... ......... (9rdifirate of Tompliatta THIS IS TO C1FY, That the Individual Sewage Disposal System constructed (4-y-Ir Repaired by......I' S;C ............. ........ ------- - ----- ............................... tt ------ -------------------;ia at.... . .1e ............. .o.. ... p.�1...... ...... ............................... .. has been installed in accordance with the provisions of TILE LEE 5 of The State Sanitary Code as escribed in the application for Disposal Works Construction Permit No----- ......... dated..... --y)"OeZ---------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCI SATISFACTORY. DATE........L..................... % ... .................................. Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD QF HEA T "71r. ................................. C2 - ...............OF.....2P�F��... ......... No..... .................. FEE.... ................ Raga�.. VorW;_Tonstruffiott famit Permission is hereby granted... _4?C!..S<0.Lj........................................................................ to Construct ep�t� an JnJividq'al, Sewage �D* sal S tem 0 Apo Lk,/ell !:.. ...................... .............. ............................................ at No.... .................................... Street as shown on the application for Disposal Work.sI.C.' oinstructio :'Permit No..."?f D ted.... ZY ....... ............ I IJ C' ................................. ----------------------- ...... ---- j- of Board of alth .............. .................. DATE............. ... ...... FORM 1255 A. M. SULKIN, INC.. BOST.0.1 r�P E ` Y Cc v stE+ 1�G✓+r Get�/v& ' � �9 � �4 Fed.✓ ,L,mr /�,A . Eif/dso.� Rtip P L 4• / �XJ2 L�AtN' x x x x x 1 `0 �P�SH OF PH4Lt. o + c WEINBERt' o 'No. 366 }, \ LEGEND r, EXISTING SPOT ELEVATION OA0 �>iyer�s /4/,,r . EXISTING CONTOUR --- p , CERTIFIED PLOT PLAN FINISHED SPOT ELEVATIONrFbt��/ FINISHED CONTOUR --- 0 --� Lor 17W �Sr �1W701.1e-- `�y ` /�IA/1S7"Dn/S /�I GLS NOTE: The Location of any existing underbi_nd sewerage, wells, or other utilities shown .on t> is ,plan is approx- I N imate only as determined from 'records .and./or verbal information. .The� contractor is responsibip for the: verification of .the existing. locations in`the •field. SCALE� �''-$O� GATE `2G �6 Elm LOREDGE ENGINEERING Ca`INE�aBa�� CLIENT I CERTIFY THAT THE PROPOSED EOISTEi1E REBISTERRQ J06 NO. ¢d° BUILDING SHOWN ON THIS PLAN CIVIL , LAND 7 �/d ' CONFORMS TO THE ZONING LAWS. ' oR..oY p . .....,.._ OF OARNSfABLE , MASS. � n�J 712 MAIN STREET CN. DYE HYANN I S, .MA$3. SHEET L or ? DATE REG. LAND SURVEYOR -^-ex 4. 4 E/:NER TslE S_=PT/� TA"V Ac OR BELO-W �i ,kADE :4 24 0D/AM ETER Co vCRET6 COVER JO FT. /N/N l StIALL BE BROUGHT To,GRADE.�i�.✓ .EX?RA t C.ONGR�TE i 4^PVC P/PE ' hEAYy CAST 1,V0/y COVER SH.41 L: IjE �JSEI� COVERS � �B: GER FT. � . • o• CsR�oB CC)VER CLEAN .'.SA/VO T'DIA. �,_ 2 2'LAYER �4. SCNE•�uGbQO '�i'1 �. . R•�z.x•. �:•;.I p.yc. J�YPE l��00 � � ;.o - • -•o 00 ( 'ol MIN.P/TcN ` GftL. , a • • • • . . . �` 0 04 WASHED 5roNE S.EPT/C TANK D/ST, o o , t s, • • . • • i •. • o a BOX.. : c c • 1 $ • .s • •�,+ .•o.o a • e �..• OEPTX • • • v WA5tJE0 STLa�YE _ s ' s o o• � .'PRECAST$EF.pAGE_ P/T OR PTV T Nv,eoot eL E 1/AT/DNS i �/3 x !. o i.s3 oX a , 10 5.5 .yids !� - i` FT D/AM F. ' erg,a /Ni'Z7?T .dT.BtJ/LD/NG FT r Fr nfar� ! C CsEE a�> /NtET SEPT/C TANK » FT. �q ., TABULA TJ 04171ET SEPTI C TANK- 003.8 ' ' 1N,GET�OISTRf6UjJON BOX ,d3'O FT. SECT/ON 4F T GRDuNo �t!f1TER TABLE u OU.TLETDJSTR/,a1J'7'/UN.�OX ro3•�'� ... x !../NL-Fr.tEstCHlJV t ?/T /O-BoO FT SELVAGE O/S/�D5�4 L. .SY.ST I�'1 TABLJLATtON ` L F.4 C/y1NG P/T T DJMEN.S/OJV ,y4 3 ` j." $CALF %4r"' a D• ' �.:: ,FT DESIGN CR/TER/A p/M.FJvs/cJv 8 s NIJlHBER OF BEDROOMS £ DJM.EIVS/O/V C. ¢` FT GARaAGE r,/sposAL uv!r_ �' $DI L TOTAL EST/MATEp FLOW_ -�°G.4L.1DAY SOIL TE5T.'A S6%L7E5741�, SDIL Tf'.�T W41M8ER QiF L04CNeNG PITS__ ELEY.• /07 O ELEY.. IDATE'OJ� SOIL TEST g�29�85 t SIDE 4--ACH/NG PER P/T ' �';S FT ': .r✓s erYlr T.w�.✓L©�l G7. '. RESULTS 1�/JT/VESSED �;30TTpM LE,4CH/NG pER PIT '1 Sq. Fr. `'` : atRCOLAT Dn�" RATE,#I TOTAL LEACHING AREA _ SQ, fT. �1SvBsnitCOLAT/ON RA7E2 M/N. INGH 3 .RESERVE l.Ei4C/•I11YG AR,6^_ '"` SQ. FT. f.. SN OF *�tjvfl } �/hE�. G: �p� /7� --Sa✓>r � �� pHILEP s\ c�c d' z 1d(FcBP%lgrFtG> �x`'� € ', '''^ x���� •. r "� " �• =3 , �.' EL DREDGE ENIs/N.EE1�T/NG CO,ING. :a .? `710 MAIN ST., _ 1�. ° .< r NO GROUND Y1ii4TER E'AICOIJ.NTE.A;Z! L</--NT 47. ,Q�.✓��ie /LP, 9 df 9¢ SHE.E'T OF' 2- Cr.20 UNL yvia TE'R A7- 6L..v�! JC7t3 N