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HomeMy WebLinkAbout0435 CEDAR STREET - Health y3s �s � �,v - �n s , - loglu►3 -- � A L SSESSORS MAF NO: 1, 0 C A T 10 M PARCEL NO.: 5 L W A E P E RMIT O. L-07 -*"51 C a D 4)..9, 5 T Er VILLA WEST IRACIIJ S-) INSTA L 1. F P.'S DAME A ADDRESS I V c u jr- VJ -M-Y-21 o u I L 0 E Oil OW K P. Vj _VO_k OAT E C 0 M P L I A 8 C E S 5 U F D it �V �l it No... .��:.�59 �' F�s.....5.®.0 THE COMMONWEALTH.OF MASSACHUSETTS �� C713 BOAR® OF HEALTH .. OF... ����T � L�. p . . .- ApplirF #ion for Disposal arks nnstrnrtinn ramit Application is hereby made for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal System at: Lo lion-Address or OL Lot No. .... . r� .t� l fl......................................................... f ..................................... Installer r. Address d Type of Building Size Lot.,..3...�t.120...Sq. feet Dwelling—No. of Bedroom ............................................Expansion Attic ( ) Garbage Grinder ( ) a aOther—Type of Building . .-MSe.._.......... No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures .•••• Z_13.617 ----------I...................................... . W -- Design Flow...LLQ_. -./rt3....gallons per person per day. Total daily flow..........................f�.............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 ( ) Dosingtank ( ) Percolation Test Results Performed b --. .VJ--. ..................... Date........ j, ./ .1............ a Y �F a Test Pit No. 1...............minutes per inch Depth of Test Pit....--.-�. . Depth to ground water.....................--. LL, Test Pit No. 2.......J ....minutes per inch Depth of Test Pit----.....t .. Depth to ground water........................ �•+ •-----..... e. e.. ----.•----• - ------. ts O Description of Soil------...Tl.-N=�....W.!.--E'...`�---1.-�.T.. . ....L l_�.. .. 1 ............... x -----------------------------------------•-------------------••-----------------------------------_-�r�i l�'-.;..���.�......------------•-•--------- U ----...----•-------------------------------------------------------------------------------------------------------------------------------------------------------•---------------------------•-------- V 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 iITL%. 5 of the State Sanitary Code— The undersi ed further agrees not to place the system in op ation un '1 a Certi ca a of o pliance has issued by th rd f li th. Signed ----- ••. ...--•........................•-----••---•--- ............Date......... Date Appli tion Approved BY----- a' Date Application Disapproved for the f l wing reasons------------------------•----------------------------•---------------------------------------------------------- ---------••------------------•-----•-••-••....-••••...--------------------------•••-•--••-•-------....._.. Date PermitNo......................................................... Issued........................................................ rl�..� Date . e i 5 • THE COMMONWEALTH OF MASSACHUSETTS BOARD_ OF HEALTH ._ r.. ....... OF....Ij .- '.A..�t N J 1 t t. _� Applirtttion for Dispniittl .ttrks,T.ttnst•rnrfiun V. ami# Application is hereby made for a Permit to Construct ( ) or Repair- ( ) an Individual Sewage Disposal System at: s . ................--•------...................................................................... .....:------.....................-----------------...-------------._..........---------.......---- j d ,C LAo�ation-Address , � - - .. -Sl_l.I ._..._•-•-•-•_ L"�%F/ t or I of No --- ------ - y----- r r�y ( ............,41 1.4 --- x es 1 Installer � t�yG sy Address Type of Building Size Lot �[.�_`..J...........Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aBuilding Other—Type of f �'u' ___._____. No. ,of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures -------------.--�- 7 �----------------------------- ---------------------------...... .�,aEJ W Design Flow :2�..._gallons per person per day. Total daily flow = ----..--�----------------•;dons. WSeptic Tank—Liquid capacity. .�f�__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 ( ) Y ---------------•----•-•-••••. Date_._.�_/ .� 1 a Percolation Test Results Performed b ___� :'. t_. �____ '_E% r' Test Pit No. 1................minutes per inch Depth of Test Pit________f_ Depth to ground water........................ 0:4 Test Pit No. 2------�-_._minutes per inch Depth of Test Pit________ C......... Depth to ground water________________________ ••- O Description of Soil ! t `1 i e- �� f 17 L� ro Ili.................... �•, x x- stf z. , c�j r, U .______________________________________________________________________________________________________________________________f________.................................................._____________. W U Nature ofj Repairs or Alterations—Answer when applicable............................................................................................... Agreement: / The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the rovisions of IT1-: 5 of the State Sanitary Code—The undersigned further agrees not to place the system in ON ation un '1 a Certi-ca e'of o pliance has been issued by the board of h th. Sig - t• ,. 'Date ned aApplliion Approved,BY;....;' •••• ----------- ........... --: ................................. -_<,�.."..-• Date_ Application Disapproved for the l wing reasons_______________________________________ - - - .........................................--•---.....-----------..__.....--•-------..........•••••-•---•- Date PermitNo.---•=--------------------------------------------------- Issued-..................................................... -- Date THE COMMONWEALTH OF MASSACHUSETTS (N BOARD OF HEALTH ..........................................OF.................................................................................... C�rr�ifirtt� of f�unt�littnrr S IS TO CERTIFY, That the Individual Sewage Dlsposal sysm constructed ( ) or Repaired ( ) ... Installer has been installed in accordance with the provisions- of TI LZI 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No------- tO_•-•-•- dated---------- ---------------..................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTI N SATISFACTORY. DATE.............. ......................................... Inspector.............------------------------------__--_--------- -----_........ W E.L L. (�1S"r/1 +t7r� THE COMMONWEALTH OF MASSACHUSETTS L ©IJ hsisui l-T C-lf-iZ•D BOARD OF HEALTH <" coo No..........................y _5 .-�.... FEE . ...... ........... Blop rsttl lVorkii To'nidrtulion Virmit n ,- Permission is hereby granted �-= e' j = �/ .. is t ,c ` �?. . to Construct ( ) or Repair ( ) an,_Individual Sewage Disposal System at No.......... --•- j..........�C a> ''T Street as shown on the application for Disposal Works Construction PermitNo 1� _ Dated_.____._..................................: ... loaa DATE................ _.�..�_. ................................................ rd of Health FORM 1255 HOBBS &—WARREN. INC.. PUBLISHERS • � ti 4.9 �-o Tr 5! 37, l28S� q � REServr Q — � ARIA ;5 I R PIT O 10" h N #®D6 AtiN EKesrp�� N �VND�4T-ba ^' S 7 32 28 ` D QQ �1 �1 QI (� W4u 176,7S 1 CZrFMFY THAT THE FOUNDATION MOWN DOES NOT VIOLATE ANY 7KISTl,Mv ZONING REGULATION OF 'HE TOWN OF �., FOV1JDl47- 10Q CEP-71FICXTIOK1 j. �� c.rxc 1) -�-�pS �r�1 7 C-� � z��� s� � 11 i oES /GN _. i SINGLE FAMILY DWELL/NG N_0 G A P e.A G L- D)-5 PO ;A L_ LOT .5 I ae - 3 a DAILY FL_ow l/ D x 3 - a3O G. P. D. 3-71 ! Z ± 0 ?' SEPrIc TANK ( VOL . 9EZ71/) ) , F� - .... G.P. D , GALS. A0 uJ c1lo10 ' GAL . TA-N - i , D IDS PD S A L PITY D/A . X �,ii(]P 7 / 7 ' o� �. r U I y EFF-= Cy1VE DEPTI-! _ �.� _ � j J �Jkk oz { CAP TY • '1?' XzX x ?J_ _ 47l w158 a TOTS � L C/A PAC IT Y = �. GALS. F-: Sv►Zv Ey I-- o ro IL a �Y Crr+� L _ I TE ST Pl iS 8' PERC TEST I (ASSUMED � - r 'i"OP OF WALL J FIN.GR.�L. �S•.-Q. EXISTING GR.E L.'� O ED�t, _ te I � `; cG: X 140-TE: REMoVE ALL IrMPElz\/1UUS M� .r Aa nXX TA 7,Fu)ALS \o f AROL4b C� [A;, 1 n I INGSBURY ,- 4"PVC P,1SFPS 1• 3 NEEDED t 9.� � ! —gam �No.2G5 s -, �, #261oi- f 'r�HE �. Irbil 9� _�/ g9 jwr+/rE /ter' ' F v •. - FS�TE��`�'/ !,9 C/ST E RN - , it �V1=. � S/DNaL��' SUiiV, 7-5 GAL. 1. �o� X �� P, C.G0NC. ; - z, N�, >-► . GELLAR FL042 . ---- IO'MlN,— P.C.COhC. C , EL. 91.73�J SEPTIC 1NJ. ` = D 1SPoaA L Pt T" TANK I q, ► E 13p� ►�'h' { SEWAGE 0ISPOBAL SYSTEM OESIGNI F o I� W AS H E b S-fC)N E c, a' 6�� 7 loll FC• A M E --IA C-k C-J�I SCALE P ALL ARoumD WA��SIDE L_PNE HOR7... I" = 10' FL. .--- LAYrz1Z PC AS TONL �J. A :NETABLE , N1� VERT. t vN TDP. Dry I ' LOT 51 I C �DA�Z ST �J. UAT:N �7.A NIA . PRDFILL= OF DISPDSAL SYSTEM - -- - - _ LaNTEFtY ASEDC. I`IDT S E : DISPDAL SYSTEM TO BC- GONSTfZ.UCTE'b fN STRICT � — I —� ON LT � E.SAND. MA . ACCD,RDANCE nF rl0"M . 0F MASS. �. MVIRarI, GObE TfrL E:. ��S. TE5-rE.O:.q��SIPI C SU , E-N& , IIG'►2 '. LDI�(... ...W L_L�f2 DATE- - -71/1 '1,9 ❑ WG. - — — --- Na