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HomeMy WebLinkAbout0077 WHITE MOSS DRIVE - Health r� � � ` S � TOW OF`BAR NSTABLE �, 273 �-� M�ss �� SEWAGE #LOCA VILLAGE 1N �c5 � l o�n 5 ASSESSORS MAP & LO INSTALLER'S NAME & PHONE NO. c c)�� 7 cSo r^� SEPTIC TANK CAPACITY 1,ooa yw tle�,,S LEACHING FACILITY:(type) r2� �c,� 0 (size) b o 0 ,NO. OF BEDROOMS 3 PRIVATE WELL O PUBLIC WA ER BUILDER OR OWNER DATE PERMIT ISSUED: DATE .COMPLIANCE ISSUED: 2�" XLI _9 7 VARIANCE GRANTED: Yes No 3s t� �a �� .� ��'" � t.-� � �� �r,se�Kr - 03) b 51 No. Fss.. .... ..... THE COMMONWEALTH OF MASSACHUSE17S BOAR® OF HEALTH ........OF.... Appl ration for UiopooFal Murks Tunotrnrtion Prrmit Application is hereby made for a Permit to Construct ( V) or Repair ( ) an Individual Sewage Disposal System at: ---.D.auc/ ... - wu ................................... Locatio -Addressor y i i2.1 ......�.o�F�:-•----------------- t�:..� ,�.,a!.D/Add IAt�����,a1.LC� �. Ow fr ress ►:ln- ..__.. isce.�.-------------------------- --- :....._......__... ---------------------------------------- .... Installer Address UType of Building Size Lot...... ....5.1Z....Sq. feet Dwelling—No. of Bedrooms............ .........................Expansion Attic We) Garbage Grinder (A� Other—T e of Building No. of persons............................ Showers a YP g ----•----------------------- P ( ) — Cafeteria ( ) Otherfixtures --------------- ------------------------------•--•-.•-••----------••......•-----------------------------•---------------------••••............---- W Design Flow.............. ....................gallons per person per day. Total daily flow..........._.__-�__Q----. .............gallons. WSeptic Tank—Liquid capacity.149.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 Othe- Distribution box ( ) Dosing tank el '~ Percolation Test Results Performed by. .i-_"..._ 6----•,-----_-_---••-•. Date_....._t1 ---------- Test Pit No. 1___..._�._..a minutes per inch Depth of Test Pit.................... Depth to ground water-.__-...___-_-__-_-____. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ......-.....- -----•. O Description of Soil.._......_..d�.""..._.._ v�J��______ ... . . U -1Z i / ---------------------------•--•----------------------------------------------------•----------------•------ W -- � . UNature 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,L_t p= 5 or 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. Signed_._.i-2.�" f.� .. V �� .. _l. -D e ^� Application Approved By......... --- ........................................ .....----- �� . Date Application-Disapproved for the f ollowi easons---------------••-•--------------------------------------------•----------------•-------------------------....._ .....--•--•--------------••-•-•••-•-•-•-•....-------------•....-•--•----••--------•._.......•-•...•-•---•-•-•-------•----•-•••••••-•---------------•-------------•-••-----------•----•--•••--.....------ Date Permit No...Y-.7........ .......... Issued-....................................................... Date t F. i No.12. ..� .� Fu$..1.------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH n , . ......_OF.....:fe......>�.1t.�`'.�.J•... ........ Appliration for Bispoa al Works Tonstrnrtiun Frrutit Application is hereby made for a Permit to Construct or Repair ( } an Individual Sewage Disposal System at -• .:.f..r ,.�..........f,:-- i•=..... -=---- ----M ................................... i Locatro Address or Lot No W 02r f Address - Instalier Address dType of Building Size Lot..... _ ....Sq. feet U ., Dwelling—No. of Bedrooms..........._..........................Expansion Attic (1't.W) Garbage Grinder ( ,) Other—Type T e of Building --_____-_ No. of persons........................ Showers G.1 yP g ---------------- - P ---- ( ) — Cafeteria ( ) Q' Other fixtures ----------------------------•--- - W Design Flow................:-•- 15......................gallons per person per day. Total daily flow................ ..................gallons. IY4 Septic Tank—Liquid capacity..P 3.gallons Length................ Width................ Diameter________--__-• Depth................ 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__./a;.�, _ . ._:,r..=f_ --_ Date_..___..__z:_ ______f a ,-- Test Pit No. 1........ ._..minutes per inch-"Dtpfh of Test Pit.:_.__: ....._. Depth to ground w �.�>_ ........ 0:4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -••---•-•-----•-----•------•••------•--------•----•-•-•-----------------•-----..........._.._......--•-----•-•-•--•-----•-•-•---•--•••-•--•---••---•--_...-- 0 Description of Soil.............-r ;, rs ............. ------------------------------- ---------------- Ur_...-- . �•. --•-•------------•----------•---••--•-••-•----------•-------------------•---••--------•-•-•.•----••------------------W = �i---•-•------- x 1 t U Nature of Repairs or Alter ions—An r`w n applicable............................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TT`I 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. Signed �=ct : _,Dater ._!: Application Approved By-------- -- ------�"""•- _ ------------------------------------ --------- ate r D 1 Date Application Disapproved for the f ollowi reasons:-------•--------------------------------------------•---------•-----------------------------------••--•.......- ------•-----•-------------------•----••---•--••--•------•••••-•-------•••-....•••-•---•------•------...•-•------••--•-•--•-••-•-•----•-•-•--•-------•-•-•-•-•••-••-•-----•----•----•••••------•••---•--- Date Permit No._9._7.......... �.-�- ....> ---. Issued_ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Fr94 .........OF..... ..`.... ..................... Tatif irtttr of Tomplianrr � THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ((�) or Repaired ( } by...........-=' '=` ........ ....:..................•--•----...-•-----------•-•-----•-•----------.....----•---------•-----••--.....---------...-----•--- Installer has been installed in accordance with the provisions of T T T'LE, of The State Sanitary Code as described in the application for Disposal Works Construction Permit No...._.....�'�-..1�__.�.... dated_...'�.___ ___�_�_____________�.,- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE................. ._:- !2_- 7 Inspector_.. .. ..................................... ----------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . j '� j ..._OF..... .a N O... .... .:ct «:°�..................... S v ............... } FEE........................ lgiipwial Works Ta1ns#rnrtilan ramit �. ,a - = f ..... Permission a hereby granted.............:... ..'.E�__._ _....---= . {- �_L to Construct (tom) or Repair ( ) an Individual Sewage Disposal System at No.....L1 1_.. €•i•t •-L_f;' '-1v, a?t�- L fir[. � . `Street vv as shown on the application for Disposal Works Construction Permit Nol..f .._ Dated._ �-_.-••--__-_._ ^.... �=� ------•--•------------•---•-----•-- 1 Board of Health DATE......... _ G..":._....$..7-----.....--•----------••-•-- FORM 1255 HOBBS & WARREN. INC., PUBLISHERS A 7 ` I LOTS�14 �57 ri iq� DC,A �. L o 7- c�srxr2 1-oT .ate' 2- . PrT .101 +i loco � k N GqL M SepRC It T � 27 t (:. 22 I ..� /a 9, ' o � ` � N E a h �c �fl�/23•d _._ _ 1. / ass } kn �,aA4444Q ' LEGEND 44 ss EXISTING SPOT ELEVATION 0� P A U,L OF t� PROPOSED SPOT ELEVATION A. EXISTING CONTOUR ---0—--— L E V Y ,Ur ROSIN <<5� PROPOSED CONTOUR O No.loo50 0 ud. NOTE: THE LOCATION OF ANY UNDERGROUND o�ocIST� >� SEWERAGE, WELLS, OR OTHER UTILITIES SHOWN ON �FSSIpNP,I ` ' '. THIS PLAN IS APPROXIMATE ONLY AS DETERMINED ! `tSTU,<;� FROM RECORDS AND/OR VERBAL INFORMATION. THE CONTRACTOR IS RESPONSIBLE FOR THE al tr�can VERIFICATION OF THE EXISTING LOCATIONS IN THE FIELD. -t R- OSED B,.EVY E. t..DREDGE / sOCIA'TS,INC. CLIENT -PROP �..v ' 1� ENGINEERS— LANDSCAPE ARCHITECTS JOB NO..L4.4 PLANNERS — LAND SURVEYORS � '�'�'� IN s OR ®Ys 889 WEST MAIN STREET CH:KD.W. -i GENTERVILI.E, MA. 02632 S9�ET„�,;�.,.QB , „_ SCA.!„ s " . ,... PATE s Z /2- �D FT. M/N. /YOTF /F E/TNER THE SEPT/G .TANK OR ate. !EAC/•II/YG P/T ARE /`SORE 7-14A,,V /•o PT. /►9/N. 4"Oiq. riQAOE, fa 24+,0/AMETEK CONG'RETE COVE. SCF/EOL/LE f0 StIALL eE BROUGNT TO GRA[>.E.C.-4/✓ ,-,X A ONCRETE PV.C._P/PE C h/E,4VY C^ ST IRON OQ.VER SHALL ak- USElo +! O Cj, o M/N• P/TCN lF/N LDR/VEN/A Y COYERS YB" P--R -r. - 2 JJ. MiN. C'ONGR�TE A G7�AOE Cd VER CLEAN SANG `LAYER Pyf. P/PE i /1� /> O o- o o A P �� QF 'I8--3�B` '& MIN.PITCH GAL. • .� • . . • . • r • o OAS %a`P&M i?: Q S�PT/C TAAIX D I ST. D • • . . • • q WASHED ST2�NE BOX p • 1 $ ► • • • • • . • ° vD ° • •EFFECTIVE r ` : �; 3/4 .. • r " r • • OFPTH • • • • o WASHED STONE 4 i. - :: o r • . • • • • • ._ o ° /1-3x/,O = / /3.0 � i a. ° r • • • • • • . r p • n PR'ECAST SEEPAGE 1,VV4-A'? E'LFi��T/DNS a • •° • • • • • • • • • ' d o 4- OR /NYERT AT BUILDING /b OFT • 6 f'T. D/AM. 1/v4ET SEOT/C T.4A K 6 FT, -�rT VIA . C{SEE T�sUL/sTfON�-. ov-r4ET SEPTIC TANK 7. FT /INLET D/STi4/BUT/aN BDX� FT SECT/ON OF GROUND W,47ER TABLE O�lTLETD/STRO.BLIT/ON B0.1d�F7. � - INLET ZEACH/NG F�/T f©�•9 FT SEJ�VV�GE .DISPOSAL SYST'�/>'f —rA5411.A'TIDIV L AEA CHI/VG P/T DjAiEmyl o AV A 6~ T DESIGN CR/TER/A -SCALE : %s" _ /= o» p/ /.ENS/aN 8-�-- =T. IVUA99ER OF BEDR0'0^fS 3 DIMENSION C `f FT. C�+•�aAGEDIsPosAt uiy/r�/of✓� SO/L. LOG �o/aL TEST TaTAL E3T/MATED FLOf%t/ ?O G.44.1DAy SOIL TEST #/ SOIL TES7-*2 /YUMBER OFLEACH/NL: PITS / F[EY./Q7 9 ELEY, PATE. OF SOIL TEST SIDE LEACHING PER,PIT A57_SQk FT. roesoiL RES[/LTS *V/TNESSED B . T NGft'G 907-TO/W L64CH/NG PER P/T�� 3 so. AT. VIA r --sv����� PEI�COLAT/ON RATE rtOE I — !'¢YAI INCH TOTAL LEACHING.AREA =�SQ. FT. PER-CO ALA 7-/ON RATE A2 �'71N�iNCf7 RESERYELEACHING AREA 2�rt SQ. FT. j OF yt Q ti L Z- (oo P AU L 'ty vi��LL Sr4N0 I o L E V Y U, M UN D� No,ioo5o Q J ,Ga T3 Gclf%/Tc f�0oss1 e� rtn dE1_> fi�o ,ST�� LEVY.& ELDREDGE ASSOCLA�S-•` '^ /0 rc JQO UA/P U AEG• GI 3 9 889 WEST MAIN STREET CENTERVILLE.,MASSl" [}SE S NO GROUND QTER EN� UNTFREo C[/EA/7" FFtG!L! 7" /r�. R GRO UND 11/,4 �P A7' ELE�! aF JOB ND, fO Z SHEET'. .. , - rY. .... .�. - >:'t:"tkY-•'y2"°Yr»{7A,'wY?k.'µ"'.R.nCeYc�3.i' Y -.k..:. Y."I... �r