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HomeMy WebLinkAbout0023 SYCAMORE STREET - Health (2) �3 ��c_,ax�o�cc �ee�, N��ax�'S _ :� � 3c o -���' NoSj•"7 i Fiz$....3 ....... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ............... .............--.....OF.............................-......... Appliratiun for Diipuual Works Tongtrurtiun ranti# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .. Location-Address ............... • � -- ....... •.. •-- •---- r Lot No.......................................••- W r Address a : __ ........ � Install Address UType of Building Size Lot____________________________ fe t' ` �-, Dwelling—No. of Bedrooms............................................Expansion Attic ( . ) Garbage Gri e, ) Other—Type of Building ............................ No. of persons............................. Showers ( ) — Cafet Oth�fjxtktres ................................ W Design Flow....... .it...... per person per day. Total daily flow-----:................................. ...__gallons. WSeptic Tank—Liquid capacity............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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ rs Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 a ••-•••--•--••-------•-••-•--••••--•-----•-••.............•...--••••••-•••---...-------......._---•-•......................................................... Description of Soil......................................................................................................................................................................... x U --------------•---•--------•------•------••--------•---------------------•----------•-•-•-----•------•••-----------------------•--------------••--•---•-----•-----------------•••--•-•••---••..._•-•--- 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 iI'IU 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 the board of health. W. .......A -�-------------------- ----- ......... ............. Application Approved // �n D 2� ---------------------------------------------------- .Dat.... Application Dis prov orthfollowing reasons---------------------------------------------------------------------------------•--___.__ PermitNo......................................................... No..��"�."j'.. F:ms.... ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............OF......................................................................................... Allp iratiou for Dinpotia1 lgorkii Tontrnrfiun V(ami# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: d%^ t Location-Address r or Lot No. Address ....--•-•-•--•.............................................. .•----.....----•-..............--••--............................-= Installer Address Q Type of Building Expansion Attic ( ) Garbage Sq. feet Size Lot................ U Dwelling—No. of Bedrooms............................. Grinder ) '_l Other—T e of Building No. of persons............................ Showers ( ) — Cafeteria ( ) QIYP g ---------------•------------ QOth t, res ---•-•-••------ -------•-----•-•....--•---------.....-----•------------•-•-•---•-----...-•--•------------•-----•......------------•.........._...---- WDesign Flow..........................................gallons per person per day. Total daily flow..:.........................................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 ( ) Dosing tank ( ) PercolationTest Results Performed by...................................................................----... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... Test Pit No. 2................minutes per inch Depth of Test Pit.....-.............. Depth to ground water........................ cx -•--•---•------------------•-•-•-----------•-•--------------•••....-•---..........._......-•-.........---------•-...--••----•-•-•---•-......----•..........-. ODescription of Soil..........................................................................:............................................................................................ U ---------------- •------------------- •----------------------- --------------- ------------------------------------------------- •------------.._..---•--------•------- -------------------------.----- 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 issue{i the,board of health. ------------- r � f D Application Approved � °_;_7.._._... ••�f.�® �'-------- PP PPY - -----y 1��„ Date Application Dissa proved`f/or-'the following reasons---------------------•----------•----------------------------------------------------------------------........._ f f.._..... --------------------------- •---------------------------------------------- •-------- ........-•-------•--••-------------•---. Date PermitNo....................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE LT .........................OF..... .......................... Tntifiratr of Tompliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (Y) or Repaired ( ) by ...•-..- --••�•..................... A. •••..... .... - _..-.../........----.......------........---•-•------...-•-------•-----•••. �.f . .Installer '�Jl .. .... ''mod J -- at........... ....• •-/ 'r° !.--- - - '------- •- -----------------------..--.-----•---------------- has been installed in ac p���o��rdff nce with the provisions of T�; gf T State Sanitary Cod as ascribed in the application for Disposal Vorks Construction Permit No.. -----•--------------------------------- dated� _..- ©/- a�" -------.----------- THE ISS11 NCE OF THIS CERTIFICATE SHALT. NOT BE CONSTR D AS A GUARANTEE THAT THE SYSTEM W"e NCTION SATISFACTORY. Ile DATE... ....................................................... Inspector ........................................... THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HE LJki ...//l?ft............................ ... ............................................ FEE1.0................ Disposal Workn T-1ontrion "anti# Permissionis',herebyr granted.............................................................................................................................................. to cork tr ) or Repair ( ) an Individual Sewage Disposal System at No ,......:-/.........................! � .................4:--•---••--------------- ------ �. Street - Street � as shown on the ap i tion for Disposal Works Construction Permit No---- --- -------- Dated/, __?.................................. .............................. ---- ----------•----•--••-----•--------------------------••......_...._ /O Board of Health DATE ��-----•-----------•----------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ao w i i}-I J =GY Y ,RBERT Q: f� !. CA Na 29874�� �NU SUR�� Ijl �_ y ice.• � . ..'r �: ii l bp 26 IL v ♦ � CV V �X�.1Nri��1 11CH, , d% r F,.J 4- . _ /4 L o,ti - 5o�p� N/F .JAN& LEGEND �'� CERTIFIED PLOT PLAN EXISTING SPOT ELEVATION Ox0 �� °FjMss EXISTING CONTOUR --- 0 -- �a,� FINISHED SPOT ELEVATION [ A. FINISHED CONTOUR 0 kS1= IP! Plo.10951�4 APPROVED , BOARD OF HEALTH Age GfvfE-: C' '_ kl VAS L. ,bl SS* ONP- DATE AGENT SCALES �'n;, �. U DATE j'-rz •s f �r_.. LDR'EDCE ENGINEERING CQ IN /Fz-1 � •� CLI�NT� 1 CERTIFY- THAT THE PROPOSED 2 1 S6 BUILDING SHOWN ON THIS PLAN EGISTERE FtEtii3TEftED JOB NO. CIVIL LAND CONFORMS TO THE ZONING LAWS DR.BY, ,/s i J %ENGINEER SURVEYOR OF BARNSTAB E , IAS3. 712 MAIN STREET CM. 8Y H Y:A N N I S, M A S S. SHEET OF, DATE �_HEG:: LAND SURVEYOR , J. 3: 20: FT. M/N. /YOTL� /F E/TNER T.r,rE SEPT/C TAN K Or? t ,—EACY//VG ?/T ARE MORE T/Y.q."/ /2"BEJ-0.4V /p /eT-M/N. ::rRAOE� fa 24'O/AM ETER CONCRETE COVER SNALL gF.B,40tJG.y7- TO GRADE. C.-;,v EXTRA. CONC/?CTE 4�PVC. O/P1r hE,4VY CAST /RO/Y COVER SI-1,4 0—= USED �C"vt q a f- COVERS M/N. P/TCN /F/N DR/YEiNA y ►•. �B ,PER FT. CO/YCRE TE CO VER CLEAN S'A/V O _ &ACJC,=/L L. o ..'e'4-CAST- oF Q M lTC�I , GAL. 1 • . . . � e . N. a_ 4 AS F H O. TLC S . . o YY NE D I ST, J • . • s "P �e>? PT/C TANK 1 c 5E_ BMX • e t• • 1 •EFFECT/VE • ,y o i•VA3WED STaNE 0 e e k o = 7 v . e. . • • • • • . . . d, P PREG45 T SEEPAGE P T D / r . . e o R UV 61 !Nt/Bl�?' CLE✓ T/ N _ rr c.���-- l - S'��� ,L l' c-LC- may, z P INVERT:AT°O!J/LD/NG 9,6:s FT.. 6 FT T T o E UL.4 !ON 9�. 1 FT O/A1►9. C�S E A8 INLET 'SEPT/.0 Ti4NK fT � �,I 1" S S z �' OUTLET SEPT/C TANK FT _ / /G 9 5,6 GROUND WATER TABLE ! t " /NLET O STR 8 T. 80X � SECT/ON-OF OCITLt7D/STRJBtl7/ON BOX /N< r cr.vc!/inrG•O/T. Fr, SEZVAGE SPASA L SYSTEJ�! , P/T TABUL LEACH//VG AT/D/V ¢ C/MENS/ON A. 3 FT. DES/G/V CR/TER/•4 Ns o G 8 Ft. D/.•fE / N NUMBER OF BEDROOMS 3 D/MENS/ON C 4 FT /11/Al• - G�RQAGED/SPO.SAL.lJN/r Al SO/L LOG TOTAL-E.3T/MA`TED FLOW. 3'3 O 0.44./0AY . SO/L TEST A/ SO/L 7E'S72' SO/1. TEST MUMBER of teWAc/ltNG P/TS_1_S fELtK 9�3 �-ELFY., 9 •0 PATE OF SO/L TEST SIDE LEACH/NG PER"P/T Sf.� FT. _ Z RESULTS IV/TNESSFD BYE RC -7r �2r� BOTTOM LE�ICH/NG PER P/T 7{ 34.. pT.. J ra.� r z .k PCRCGLAT/ON RATE,*l L4E:ss M/N INCK TOTAL 'LEACH//YG AREA 2� �� SQ. FT., s r _� gf" AENCOLA7^/oA/RATE�6E2 � `�^J/ylN.�INGN RESgR1iEGEftC'N/N6AREA "�-'-' SQ. FT. "~ Ci9 z v L) - ,o', •� '....�,' .�, ��� Sot L. i r_ST r.S`' f•' - 1 3 3 `.� { •� Nay �, a Al •.�R���� i �1y f T/S ';✓ .pill N A �` b l :Li ':`�� 'Al A."', t ' EWSA \v MORSE NQ Y9874 x t J v _ o t� LD E KEDGE EIVGI A/EER/NG N . F �o. 1�951•p C� � C G�STflekLLJI I I LI .. !' . '? 7/2 MA/N ST. , HYf)rt/Al/S; MASS. 0 < p 1� ,P' d Np JA' ��'%/�' 0 /YO GROUND 1�Mi4TCR ENCOUNTER60'.„ CL/EN T.`R,tc7_�v �Py� G1 G/e 1 U�VO 1-�/ATER AT ELEv _ .JOB NO; S �. t ti E� SHEET�OF �--