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Home My WebLink About0415 MISTIC DRIVE - Health q15 ryl Ist-�c-!Dri've- mctrstass Dlvt - ba8 -731 LOCATION SEWAGE PERMIT NO. VILLAGE j uYS INSTA LLER'S NAME & ADD`RESS Yc Cay, S' � B UIIDE R OR / OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED lti l� .ice � �9 � �� II No................`5--- - '<: Fps........•••••5........... THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH ......OF........... ae- ._...................................•----------- ...........raL . . App iration for Uhipoii al Workii Tomitra rtion Vamit Application is hereby made for a Permit to Construct (X� or Repair ( ) an Individual Sewage Disposal System at: ...................................... ��`r----- o-$T-e----D�---------------------moel 3 Location- ddress _.� or Lot No. �L. 9 c-S°1 - ,0-I-t-�'r_V-- --•--..... . . - �o I y_.� ...i�j•--- 1.� ......dIs Owner ---••--•------••••-••-•••------_Address Installer Address Type of Building Size Lot' ,,_35.Q-----Sq. feet Dwelling—No. of Bedrooms._._,._..................................Expansion Attic ( •) Garbage Grinder (A) Other—Type of Building ........... No. of persons.... Showers ( — Cafeteria ( ) Otherfixtures ....... o'- gti...7J a..ada.-C-----------------------------------------------------------------------------••--------------•----------- W Design Flow____ ______________________________________gallons per person per day. Total daily flow............................................gallons. WSeptic Tank{Liquid capacityj�=11--gallons Length................ Width---------------- Diameter................ Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length...........�.r Total leaching area............ _sq. ft. Zo 3 Seepage Pit No. ,.--------_._ Diameter......{-Q....... Depth below inlet........19._...__. Tg al ching_area_._. ��_sq. ft. Z Other Distribution box ( Dosing nk (r/) ®' '$ .A ?X, Percolation Test Result Performed by.. a . .................. Date.....l :__3�'___�.E'..._....... a y -- ,� Test Pit No. l--- _A'._.minutes per inch Depth of Test t____________________ Depth to ground water_--__-_-_____________--. �T4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_--________._________--. a ..-------•-- /o -o---- --- ® _. --- - ------------ - Description of Soil.._..:.. -._.el.__` _-.. . .. -.......:........•--_{------------ �� 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 iITA TL,. 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. / Date Application Approved By- -- G�?rZ �- --••-l�s ---------- Date Application Disapproved for the following reasons:.............................................................................................................. -•------------•-- -------------- -------------- --------- ••--------------------------------- -------- •------------------------------------------------------------------------•------- Date PermitNo......................................................... Issued__.?_.._ -------• --•--•••---•---•---•---•--- Date d No..........3zz FEs........_5........... THE COMMONWEALTH OF MASSACHUSETTS BOAR® HEALTH ............ ... .......OF........... aA/P 1...-r............................................... Appliratiou for UhgposFal Workfi Toustratrthitt ramit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: ••••••----------------------•••-•••.................----•--•---••------•---•--------------------- --. 1.f.5"..M.!. 1.t .-----Da-----••--------------`=•°•T 13........ Location-Address or Lot No. Owner Address ......-• ............................. a Installer Address Q Type of Building Size Lot__g ....Sq. feet V Dwelling—No. of Bedrooms_____ ________________ ________________Expansion Attic ( ) Garbage Grinder (A) a . aOther—Type of Building .......... No. of persons____)__................... Showers ( — Cafeteria ( ) QOther fixtures -------------------------------------------------------------•-•-•-------•---•--•----------•-------•-----•---•------------.._..---------------------- W Design 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_____._____j..._... Total leaching area............ ._...sq. ft. Seepage Pit No.......I------------ Diameter....../Q--_____ Depth below inlet........SP ..._. TyC hing area...2..�.___��___sq. ft. Z Other Distribution box (� Dosing tank ( ) Q'' * S'- ✓' 7d ~' Percolation Test Results Performed by...,1% i°- ..._... Date .� 3 aTest Pit No. 1----2.%z...minutes per inch Depth of Test t____________________ Depth to ground water........................ f=, Test Pit No. 2................minutes per inch Depth of Test Pit__._..._.._________=Depth to ground water........................ x -----------------------------X---- --------- ..........1-2 J ..............- D Description of Soil - ...d �� = �y'1 K-- '�'._-•-/ �-------- ............. - - x 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 TIT L;,, y g g p y of the State Sanitary Code—The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has been issued by the board of health. d. - p DateF�APPlication APProved BY.._.. - ... ...... = _..._ ............... Date Application Disapproved for the following reasons-------------------------------------------------------------------------------------•-----=•-•--•---...------••- •-------------•--•--...---••------...-------•----------------.....---•---....-•--•---------•----•----•---•----------------------•---------•-=---...------------------------------------------------_.. Permit No......................................................... Issued__. 2 :. ::f� y. .�� . ate Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......... ....OF........................................................................ (9rdifiratr of Toutpliattre 1/ THIS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by .0 ------ -- --: ------------------------------------------------------------------------ ----- /! / `� / Installer /j� -�.................. /1� ./..�.. D y at... ¢� E�! �y l•1.--... l [s =7= ...... l 6.... `l /"�1� ��C h` J"� r �' i <s.......... has been installed in accordance with the provisions of TI j of The State Sanitary C de as describe in the application for Disposal Works Construction Permit No.... .... ,. lS --•--- dated 7._'_-7.�.:---•--•-•-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON UE® AS A GUARANTEE THAT THE SYSTEM WILL FUNC ION SATISFACTORY. DATE ......... .................................... Inspector_...__ ________.._.._./..--•---•---•---•---•--:....._...-------.......--_------ THE COMMONWEALTH OF MASSACHUSETTS /' BOARD OF HEALTH /�. �....1............OF.. ..Z42,..., -r✓./ � ..... ..................:.. No..... FEE.... 5.......... - �i��tai� . l rk� �agtt��rttr#irrn rrtttit Permission is ereby granted.r..••---..)AC �..................•-.---<----------•--------•-----------r-•------•---------------.........---•----...._..-----....._ to Const ct or e air an.Iividual Sewage Dig /emf �` -',2 � :S atL -......' ... S ............................................. treet as shown on the application for Disposal Works Construction Permit No--------------_----- Dated___,�5 '._7-_.,4__:....... - - 0 .......... .......................................................-•---•--------------...---•......_.. Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS I � ,. ^.. � - !' <�� t. r .A� �'. � .. .� ` . .. •� 1.L 3Y .� Jett J.,. �,.S O 1 L. L 08 r • \X'j1( Ufll�\S/?ni'e.d/K'•eieiiss ria<�wA,rtiAJ'/ %.Li1vi ,'' Imo¢• -_'' // t r r-----�{ .r•^? PEAS!� lA�+♦AI., FILLl' �R2u MM. -'•� • . . '1- �. F �7'11'li.f. / DIST. °, •ey t'r� � ��:` '�� pi.- + • •. , ,. S h.i''' t: `. BOX �;` 00 Oe _ `�ixT4 c -A•0 J/,'• ! r /o 7! . e 24"MIN. ••r-F.0 €• /0,AlIN.�- �0 I� De ♦�< 1000.: BAi. �a01.. r .'• -• � `.� 4 + 1 GAL. —- + d°v- PRECAST , OR g.4 .o l ? c �G /v S SEPTIC 6J�eoa E3L4C!(: i~ 'aD. I TANK " SEEPAGE PIT A a 4 0 0 T4P 20' MINIMUM Ii ° " • Z�t t ! 1 FOUNDATION .:•, * - ' ' - .�I7fi.a f/YTS!IG� • 7 ` I -WA'SHED SC (d ELEVATIOPS $ETCH '�— 10, a Pt2RC•.12A'Ta c 2 ►tea SCALE I 4! �_I - a�� s rt TEST BY J. TOWN INSPECTOR- _.P WA- MU-A"% t BACKHOE OPERATOR. r TEST MADE-ON. •3 B, J.33v grad, x 0,4 V /.s � 9e 6g, qe � Q•E'ri.v. , . ReovlDEQ ft 548 TOW& OW7412 AJ,'A1L A 94E 4 �3• Ad� � 9�ks la'.j 14 �. ♦ \9I��•``""�" / ' _ €. ,! ,,,,s..✓•"'r ••.+�"� �. e• +, '�- ••�,. ANT r. �00 ie •�- '`. ,�` -� �\.�. P*\•" �r/r j -1, +• «�, .• , :?fin" .. . 001 r'e'� �'i �'_. t+T� 'F,��.I• 'f .� s /S, I � -. � `, � . t • 1 • '4' �, 4,o r�. mow. « G�d�(�' , _, ir✓.r �_ - - r c>=,eTi�y T.y.�r r�� .srrrerue — ; mot! .� SNOWY /�E12�1�N w.v1' �oc�rEro �o Ark , - .� �,`- ' ;s�.a�nlc TJeN�r ' • `�' �/YO C2a/YFl3r�Z JJ 7b rXC Z OWIIVe, BV-.l*lV S• AAE n "?.s;"; 7 p.�,, / ' oF' riyA 7VAYel of AVeiYS7A�f4,9 /MASS'. - r6 /`/ 00,0 a 1� + spy ♦ J r �Y 5L No.22597 4J'Y j �- 2 I ELEVATiOI� SCHEDULE' �! '.•;'�, . PROPOSED SITE PLAR! I INS'. AT FOUNDATION �t"1l��fL SiYMIN D28113a 2. i NV INTO SEPTIC TANK BOG e yB " ' . IN " 3. INV. CUT of SEPTIC TANK /O�lt53 E�.4R/yJTs9t�JG�� 111-9SS � 4 INV, INTO DISTRIBUTION BOX Lo�,�3 SCALE 1 -1 Q `Jzllyz 210 1978 - 5. .I NV. OUT OF DISTRIBUTION BOX G C-4144 6. INV INTO SEEPAGE PIT w /DG JQ2 CAPE COD SURVEY. CONSULTANTS ' 4' ROUTE ,132 Z BOTTOM OF PIT _ 04.0 FIYANNIS,MASS. 4, A DIVISION t08TON' SURVEY bONSULTANTS,IN0 s� E. BOTTOM OF STONE LAYER s _