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Home My WebLink About0127 PITCHER'S WAY - Health (2) la`1 P��ee.� u�y -b�c?��fis �a- tl�o -2,89- ► (Z No... :...... /=- '' � -- f,: G_ _. FRs ..... ®� THE COMMONWEALTH-OF MASSACHUSETTS BOARD OF HEALTH "-W_X)....................OF... .Cc !1.-S` .10-� _- ......'.�........................ �'d,� ApplirFation for Dispog ai Works Cfnnstrnrtion Frrmit Application is hereby made for a Permit to Construct (//(or Repair ( ) an Individual Sewage Disposal System at: .........Lo.# ......................................... Location LTA.-Address or Lot No. ................��•N........�:......t4Aln-................................ ................................................... Owner Address a -•-•---------------- ...._ -? �� ---- �.� .......-----•---• ...----•-••----•.........-••••••••••.•..... Installer Address Type of Building Size Lot............................Sq. feet Dwelling ZNo. of Bedrooms.__.___._______________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons__-----__-__-___-_--_______ Showers ( ) — Cafeteria ( ) p' Other fixtures ............................... .. W Design Flow.................. 5 ...................gallons per person per day. Total daily flow..........3.-.!>.O.......................gallons. W Septic Tank—Liquid'capacity.1Q.�O.gallons Length................ Width---------------- Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length...............I..... Total leaching area.................... ft. Seepage Pit No-------d------------- Diameter.......1_h....... Depth below inlet......( __________ Total leaching area__ _ ......... ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by................... ............................................ -•---•••• Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gz, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ •-•-•------•-----------------••-----•--•---••--•-----•-------•- --------------•--------•--••---------------------- •----------- -•------------------------ 0 Description of Soil........................................................................................................................................................................ x V .•------------------------•----------------------- 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 MITI. . 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beem.issued b the e board of health. Signed •--•----•------•• -- ------------ Application Approved By...................-- ..........LA!........1!.� ........................ ....... L/�l -- -----•----------- Date i Application Disapproved for the following reasons_---_............................................................................................................. .........-•----------------•---------•-•-------------••-•----...-•-------------•-•------•--•--------...--•••--•-•-----------•-••--•-...-••-----•-••-•----------•--••••......•••••--------••-•-•--------- Date PermitNo......................................................... Issued........................................................ Date L Fes$ ..}S �Q THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH tR.+..A.►...................OF.. .CsJ� �- ` .! :�? _'=....:•'.:................ ....... Appliration for Disposal Works Tonstratrtion Prrutit Application is hereby made for a Permit to Construct (41 or Repair ( ) an Individual Sewage Disposal System at: ,.y, ........ 17 .#...:V.....---....+thc�r� �f`X........a...�...»+5 -•.......................................................••------................_.._............. Location-Address or Lot No. �!t!1....... .:..... '•gc' trL-----•----------.._......._...- Owner Address Installer 7 jk Address Type of Building, ' Size Lot............................Sq. feet U Dwelling . No of Bedrooms........._ ...................Expansion Attic ( ) Garbage Grinder ( ) ►-U paI Other—'Type of Building ............................ No. of persons.........�................. Showers ( ) — Cafeteria ( ) Otherfixtures ....... --•---•-------------------------------------•-•-----------•------------•-•--•--......_•-•-.--.. W Design Flow.................. _____..::._.._._..__ �gallons per person per day. Total daily flow_........ .1 .......................gallons. WSeptic Tank-Liquid capacity.1Q60..gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width__!:---V----------- Total Length.............. Total leaching area....................sq. ft. Seepage Pit No......I-------------- Diameter.......U)....... Depth below inlet......4.......... Total leaching area..r2.P---sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by,........................................................................ Date........................................ W Test Pit No. 1...........:...minutes per.mch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water._...__._._..-......._._ W •------•------------------------------------------------------------------------•---•••••-------•••......................................................... 0 Description of Soil........................................... =-------------------------=-------------------------------------------=.............................................. U -------------------------------------.............................. .............................-.................................................................................................... W UNature of Repairs or Alterations—Answer when applicable._.____....................:__.._......_..._........._._....._...__._......_.__.._...........__. ......... _ ................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with r the provisions of TILT IL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has em,issued the board of health. Signed ------ - oae .............. - ............ . . .... ---it - Application Approved BY ....... ----- ... .............. Application Disapproved for the following reasons:.............................................................. _ ..............-: ._.........Date-_.._.._....._ ............................................................................................................ ----------------------------•----•-•-----.....---...----------------------------------.......-------------- = ................................................... ................................... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �!... y!tit. .............O F.... ................................................... (grdif irFa#r of„.6utplidttrr b T IS IS TQ ERTIFY That the Individual Sewage Disposal System constructed or Repaired Y �"r".` 1 4l -----------------------•---------------............------ ............................... a� nstaller i at ... . '� I----•� f�G�tX lr�.. .4`�!'b� --\� ` ��!�'1��-------------------------------- has been installed in accordance with-the provisions of T `' of The State Sanitary Code as4described in the application for Disposal Works Construction Permit No.. /__ ..,, _>,2.& dated------------_________I.......................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM----- ----1 UNCTION SATISFACTORY. 11' DATE--- ----------•------......................................... Inspector---•-- ....................................................... x �• THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH rNO. _ ( I ') ...................................... FEE. ............... Disposal,PIASorks 0—Eans#rurtion rrmit • r Permission is hereby granted-•-•---•-•--.. r` .. C t 1 to Construct 6�'or Repair an Individual Sew age Disposal System J ' at No. OA �-.-. "T....-----� tTG ke,�'.r:5...------Leg. �. --------.•-••••......---••-•-•------------------ Street as shown on the application for Disposal Works Construction Permit No.._...................... Dated.......................................... F._T�_/•_•__• /w'__ -S�_•.--�T---:-•-_---•••-•_•_-----••••-•---•--.. f hoard of Health DATE.......................................................� .t :.,5. ., �w FORM 1255 HOBBS &-WARREN• INC.. PUBLISHERS ►sue AS S riown, o P P-o b tit/F TEMPL'e s.e.3ear j To t9�� Tower m v _ o L 07 , f . 61v r. l TA A' a z o 3� + k �x nANsi oaf � (b* T.r-l— EL ,ace.oa u F ALBER . �No 10951 l c- D TH ,00 9�C��srE�ow� �S,F3: 20' `S. (3. ,C� FSS�ONA�� --- . w ASS u),AE0 P P.oTr5cr,On 1 LEGEND NOFMAss CERTIFIED PLOT PLAN EXISTING SPOT ELEVATION 00 ate- icy EXISTING CONTOUR --- 0 --- o :�� L0- yi7c rr -.,,- FINISHED SPOT ELEVATION a r -� FINISHED CONTOUR 0 �� -� "aa seen APPROVED BOARD OF HEAL 0�f, S IAS L l? * DATE AGENT SCALE, 3 DATES /z,/2..'/15 LOREDGE ENGINEER/NO CQ /N CLIENT 1 CERTIFY THAT THE PROPOSED EGISTERE REGI JOB Np. ._. q 8 BUILDING SHOWN ON THIS. PLAN CIVIL L CONFORMS TO THE ZONIN LAWS ENGI EERIAURE:c, DR.BY OF .BARNSTA W11, ASS. *e-i5`-3 . 712 MAIN STREET CN. BY= NYAWN I S,, MA$.S. '. gHEET,,.40' GATE RfQ. LAND SURVEYOR 20 PT. M/N. /VOTE : /F E/TNL'R THE SEPT/C TA V OR LEACH//VG P/T A:RE MORE THAN /2"BE40yt/ GRAPE, ,A P4'O/AM ETER' CONCR.rTE COPZ#e SNALL BE BR004SHT TO 4)rADR.CAN EXTRA GONCRE7'E q+PVC P/pE h+E.4Vy CAST /ROW C0{/ER Sh11-qL-L- SE USEO COYERS MIN. PITCH /F//V DR/VEy1/A y e,,• � PFiQ FT. 2JL M/A/. C�NCRL�TE Cy1�AOE co►lER CLEAN SANG r� • , BAGXF/LL L/QU/O LEVEL e= A ER _ z L Y :b "JIV.P/TCN 0 0 D GAL. • �. 1 • • • • • .• • e •Ao SEPT/C + TANfC D/sT, o , . . . . • • , e . WA Sh/P0 S7t7NE .� :• BOX • ' i � ;B• . • •• � .•s � (OPro"AL ` ! e • • IEt"FECT/✓L ' ♦ , 314 / �2 • • o • • AEArr" • too • , , WASHED STONE • so • • • • • • • • • • p •• q pREcA s r"&PA crr Z caPA �, Ty o Joe • • • .. • . • • � e p . P/7OR EqU/✓. . /IVl/EKT ELEYAT/D/VS /BB x Z.S ¢moo . A EL, gap /NYERT AT B!//LDIMS 9 g••S .Fr. -7 8 x / 0 6 JT D/AM. .SEpT/iC TANK 9 P•O Fr, TB rA 4- E 4' 0 alP /O FT. OG4A1. C(5EE WWVLA7-J0N,) _ 0,V 74 AFEr SEPT/C TANK AFT ': F 97.S GROUND WArEX TABLE /HEFT D/STR/A!/T/ON BOX FT. SECTION OF ;< I OtITLETD/STI�IBtJT/ON,BQX 97•`f /IV45'r LEACNIIVG IIJT AFT. SEWAGE O/.SL001S'A L .SYSTEM j LEACHING P/T 'TA�IILATtON scALE : %s' �+ /=0- D/MENS/ON A 3- IrT. DESIGN CRITERIA D/>y,Exs/aN 8�—FT• N[/MBER OF BED/�oOMS 3 D/MENS/ON C GAR6AGE0/SPOSAL l/IV/T o SOIL LOG 3 3 p SO/L TEST TOTAL ff3TUr/A7rED FLOW GAL.1DAY SO/L TEST /I�/ SOIL TEST S NUMBER OF /,ErACIIINT+ P/TS ' fgtEK g83 .�`-tLffY, OATE'OF SOIL TEST, S/OE LLAGH/NG PER P/T /8 J. fT. D RESULTS *V/TNBSSED ByJ R F e" 9orroM L64CHIIVG PER PIT 78 W. PT. Gv � r I :� PERCOLAT/ON RATE�/ ��5 MJAVINCH TOTAL LEACH/NG AREA Z�'�' SQ. FT. S v AERCOLAT/aN RATE 02 M/N.f/NCH RESERYELE�iCNlN6 AREA Zy SQ. FT. C' 2_ _ azOF f 3` yG l_ i 4 4 �JOHN N o' ALB Sc..1� /—/ ;/, ca.' f ✓vMORSE Cn!• All .p No.29874 C `BCD No.10951 CO,INC. ��s ' ;4 ��, .� 712 MAIN -9-r, HYANN/s, MASS. SUR��'y `.)`S`cf s 11 . Cl. ENT: i ® NO GROUND YYArER �NC;'OU1VT1vRE0 Nei<;••jl;r P; ' D.dTE / A GROIJNO W.4TER AT ELEI/. 1/0415 NO. SHEET_' O/s