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HomeMy WebLinkAbout0381 HOLLIDGE HILL LANE - Health 8P Hhllidge Hil F L'ane"" ­_ -- Marstons Mills, A= 081 -013' L 0 CATION S E W A G PE RMIT NO. VILLAGE lynewAivt MAZ INSTA LL R'S NAM - i DONE S d sull_iut OR OWNER 1 DA T E PERMIT IS-S D J-AV /F l � DAT E C-OMPL.11kk-CE ISSUED v o- a? t o =imp 5 F A� g e p�buse '. vs C ��.5 Fiz$....... � . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - -------------0F A.F sT bj- .r.......:........... ApplirFation for M-spos al Warks Tnnstrnrtiaan Prrutit Application is hereb ade for ermit to �Cp nstru t ( ) or Repair ( ) an Igdividual Sewage Disposal System at: /�fs� ffo G6v S � --� .. ..........Ih YOAI A ------ -- ----- ! ...... Lo tion- dress or Lot N o. r s ......... .............0S ��c:�LLe------- i. ..�..........-- �wner r /,/�, pp�� Add ^ice. ---- -�' - ............ .. ................ ............. ....--- ........... D..•-- !�LV..-------.. ._....C`.c__:._..s�----•-•------ q � Installer Address d Type of Building Size Lot............................S . feet Dwelling—No. of Bedrooms Expansion AtticO�' Garbage Grinder r—T e of Building No. of ersons-•••••--•---•-•............. Showers — Cafeteria p,, Othe YP g -- - -- -� P ( ) ( a Other fixtures -------------------------------- ,�` --•-•-•••---------------------•--- W Design Flow....33.0...........................gallons per person er day. Total daily flow............... .._I.3.......__....._gallons. WSeptic Tank—Liquid capacity �_60.gallons Length_r..Q..._.. Width..--.-.lt_.. Diameter................ Depth.'Vmk.. x Disposal Trench—No. ..... ..-__ Width_.N/-':-----• Total Length...I i ....... Total leaching area............. ....sq. ft. Seepage Pit No......I-__--_:-___- Diameter._�0___�Id....... Depth below inlet....Jj..y7... Total leaching area..5-A. ft. z Other Distribution box (] ) Dosingtank ( ) i `'' Percolation Test Results Performed by.__ _. _..mQ 1g�!1 -....� _`............. Date....1.1 6.� �___..... ,aa Test Pit No. I......In....minutes per inch Depth of Test Pit-.15-6...__. Depth to ground water.....Al---•-•____. Test Pit No. 2.......1L.-:._minutes per inch Depth of Test Pit---- ..... Depth to ground water._..ly ............ ODescription of Soil............... CAA.1....... =q-�•a C:...-•------5....s✓......-------------------_...-------------.----------•--------------- U -•-•-••-•-•-•••-•-•----•-•--•----•--••-•--•------• ••-•••-------•-••••-•................I..-•-•-•••......•------•-----•-•-•••-••••----•--••---.....---•-•-----•-•••••---•---------------•••-•-•---•••. W ------------------------------------------------------------------------------------------------------------------------------------------------------- ......... ----------- UNature of Repairs or Alterations—Answer when applicable._____________________�f�:w..____._..�,�.� ..._.._._--__...--. •------------------------------------------•---•----------•---------------------------.............---------------------------------------------------- --..................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITI 11 5 of the State Sanitary Code he undersi n d f ' .er agrees n to place the system in operation until a Certificate of Compliance has been ' the o !L 61 ........... ..Signed-•- -----...- . ........ .........•----•-----------•----- - Application Approved By---------- Date Application Disapproved for the following.reasons--------------------------------•-----------------------------------------•---------------....••-•-............_. ---------------------------•-------------....----------------------------•--•-----------------------•---•------•-----••••••-------•----••-•-•----•••--•----------•-----••---•••-••-----••-••---.......-- Date PermitNo......................................................... Issued....................................................... Date No.... THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH ......... . .................OF. _5.,4'Ge.S. ................................... Appliration for Disposal Works Tomitrurtivit Vamit Applicat;pp is hereby made for a Permit to Co 'truct or Repair an Individual Sewage Disposal 3 System at: ....9 t.L...L 1A 0 Gill LA1....... .. ; .. ..... .nss....... 1 ) 7 ....... ) _ ......... L on-Address ....... LoI.No....... ai�j...... ....... ................ ... .w..n.er ........................... ............ o "Fc . A..d..d.r.1 . .. . N.... amd - ....,.. ...... S ...... Installer Address U Type of Building Size Lot............................Sq. feet tL Dwelling—No. of Bedrooms.._.`.___.).......................Expansion Attic Garbage Grinder Other—Type of Building .......... No. of persons............................ Showers Cafeteria Otherfixtures ......... ............................................................................. ................... Design Flow.....3.10...........................gallons per person per day. Total daily flow..............................._...........gall.. ons. 1:4 Septic Tank—Liquid*capacityjf.Wgallons Length.8.-..O..... Width... .:'h... Diameter................ Depth..4/ Disposal Trench—No. ......A.M._. Width..A//�........ Total Length-__A!6. ...... Total leaching area--------------� ---sq. f t. Seepage Pit No......./------------ Diameter...6..--a...... Depth below inlet..... Total leaching area...........Z...Sq. ft. Z Other Distribution box Dosing tank ( ) ........ ....V1. 'iNAI&A.14.,J —S Percolation Test Results Performed by._.......I ......... ............................... Date._...W6 J811�) .. ........ .................. Test Pit No. 1.......�...minutes per inch Depth of Test Pit... . ..... Depth to ground water......A/Y.......... GX4 Test Pit No. 2.........Z---.-niinutes per inch Depth of Test Pit-__-- .... Depth to ground water.....IV(I........... 9 ..............................................................................m.............................................................................. 0 Description of Soil---------------C.ZfA ........C.g.yl Ir............... ............ ..................................................................................... ----------------*-------*-------------*"-----------------------------------"------------------------------------------------------------*---------------*-------------------------------*--------------- ...............:.......................................................................................................................................... ---------------------------- Y U Nature of Repairs or Alterations—Answer when applicable------------------------- .AI....0.......W...........y ........................I.............. ....................................................................................................................................................................................................... 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 i e by the board of health. Signed ... . . ............... ......................... ................................ Date Application Approved By------------ Date Application Disapproved for the following reasons:.............................................................................................................. ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............. . .............OF....... .............................................. Trdifiratr of Tompliana THIS CERTIg, That the Individual Sewage Disposal System constructed lfoo"') or Repaired by........... ......................jr_4 �................................#.................................................................................................................. -- Installe2� -0 at.............. /.?........:-, --------------------------,--.----?2-4-A..................................................................... has been installed in accordance with the provisions of TIT L Ill Z4Z 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No_e.............. ............ dated________________________________________________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE... Inspector..... /I'- ........................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 0 F... .................................................... No.0-2 ............... ....... .... ... .................... FEE........................ Dibpooal Vorkg TD.Onstriu-tion - ..I - ----------------------- Permission i granted------ ...... .... !111ereby gran ....... ......... .... to Construe j or Repair an Individual Sewahe Disposal System 7 /-> A- I Al at No.------ ......................... e t- lyle c A f ...................................................................... ................................... Street as shown on the application for Disposal Works Construction Permit No--------------------- Dgted.......................................... ............... ....... ............................................. 'ard of Health ................... DATE-.... ... ......................................... FORM 1255-HOBBS & WARREN. INC., PUBLISHERS u 4,z— f .... � rti 2. 41 A , a t - � \rye;Sy}J Z} [j `f� • 0 34.QU �,q,vh'OG �S GO!/��S 7"o +QF By/Gr' TO Gl/irN/�/ � ' Tcov.vo� T/O•✓ Q 00 , „ ivis.vEo e�o� 'tii 2 S Z,�AyEAe e... laic-5-C 2/+ N S",S Zp. ' p I; g °•; 20u fi s r. :.CC)) b� E�7- SE. r/G Ti9�/.� o 1AV4!5E'f 8oX r} WV pAR 0,o; CvfISHEo ST�✓� �� •�.;c /D � GA.e B A G E I-.r-- � ---->� �� ' , 4ji�v. G.e IA/O c.•e ' ice-- y , o,� 0/ 7- d PROFI LE OF ' SANITARY DI SPOSAL SYSTEM NOT TO SCALE DESIGN DATA 3 BEDROOMS =� CONSTRUCTION OF SANITARY DISPOSAL DESIGN FLOW 33Q GAL ./DAY SYSTEM SHALL CONFORM TO MASS . LEACH RATE -'G' _" MIN./INCH ENVIRONMENTAL CODE TITLEM PROPOSED LEACH CAPACIT Y : AND THE TOWN OF ' '"`/ c1 HEALTH REGULATIONS. iC/©T E G A L. D A Y. ,Cl 7- G o G/�l`10 l �( ° ,��.�G,G�.�/ %v �//� ��az,.� T/�/��,,r,� /�','� G t�c�� �.-a�.•���/G A rZ..... SITE PLAN SHOWING PROPOSED CONSTRUCTION LOCAT1ON �/Y/GG . k'-A1,5 1% ` emszD_A ' - r. FOR /G'�/ 3 G` .. .31Z—I8 -APPROVED I9 �_ ' _ zrEv/v20 BOARD O F - -HEALTH SCALE: - D A T E �� -- z///f z. R E F E R E N C E: /'4' GvT /� -<S. '` ''` // .6 A,/ , `i el6- , �5'7/y-', DATE A G E N T 3C11Up"M ' }', ,> >,:_ � is �T� mo ' rn M � t36dQ J . M. MONAHAN ' JR . & ASSOCIATES QI REGISTERED LAND SURVEYORS & ENGINEERS �� '-, .� 1 �� 651 MAIN STREET DENNISPORT, MASS. 02639 /�S' i r 7.4 QJw Z7,�Z /op xavat V /,Ot , � ljo 6G t� 22. ! 7� / P.0 F> � A 7-10 - �-✓c_� .��.-r� -r.�..�tom, '�.'C��` r�-�° �D . SITE PLAN SHOWING PROPOSED CONSTRUCTION '` ' '' F OR : ' ''' 'Q - " APPROVED 19 SCALE "'J?= DATE : � '+ f ` � - B-Q-A R fl O F H E A-L T H REFERENCE DATE AGENT OF JOSEPH M. t3aao "f J . M. M ONA HAN, J R . & ASSOCIATES g y PAso uv • ,, , _ ;, REGISTERED LAND SURVEYORS & ENGINEERS ' 651 MAIN STR E ET DENNISPORT, MASS. 02639 w ,{