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Home My WebLink About0031 MOCKINGBIRD LANE - Health �� r � b(��'��v✓i��1i ' 1 ` ° Irk ' 4 A No,?.3 r®�... Fps ........... ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... .... . . ... ...................OF............................. -............----.------.........--••-------.I............ Appliration for Mipa al Works Totuarurtion Frrutit Application is hereby made for a Permit to Construct (V/) or Repair ( ) an Individual Sewage Disposal ystem t / Loc Lion-Ad fss o t No. Owner ress...... Add Installer Address Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ................................. . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W Disposal Trench—No. ................ Width............... Total Length.................... Total leaching area....... ....._....sq.x Septic Tank—Liquid capacity............gallons en ................ Width................ Diameter................ Depth................ Seepage Pit No-----_-------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. 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.....................--. (z, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... �+ •---•---•--•-------------------•-••---.....----.....----------•----......................-----••-•---••--••-•--•••-•-...---••-.......-•--•-----••••-•-...... 0 Description of Soil........................................................................................................................................................................ x w •--------------------------•-------•-----•-••--•--•------•----------••••-•••--••--•---•-•-••••••---••••-•-•-----•-----•-•------•-•••-••----•----••••••---•••••-•--•-••------•----•--•-••....•••--....... VNature 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 iITI,L 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee i sued by the board of 1 ed. •- - -------•-------••--- .<?.... ApplicationApproved By -- ------------------ --------------------------------------•-•------•••----••--------- -----�-.--•--- Date Application Disapproved r the following reasons:.............................................................................................................. . ......... -•----------- -... ......... PermitNo......................................................... Issued........................................................ Date ------------------------- ------ No,:�....=..... ....... FRs..... �.............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................... ....................OF.............................................----........-----...........------........... Appliratiun for Uiipuiittl Workii Tomitrurtiun ramit Application is hereby made for a Permit to Construct O or Repair ( ) an Individual Sewage Disposal { #ystem at• t' .o t�qN/ Ln ss ,y.ol..--.-..&-A17TX-V126E,....... iA --� 7---h Owner r,lQ Address a .............. ...f�� ---•--..............------.......................... .................................................................................................. Installer Address Q Type of Building Size Lot'....................::.:. q.............................. feet v S ., Dwelling—No. of Bedrooms...:........................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No, of ersons--.......................... Showers — a g p ( ) 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.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........--.............. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f� _- ----------------------------------------------- ------...... -----------.....--------................•---------------------- ..... 0 Description of Soil................................................................................................................................................ ................ x 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 TIT1Z 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee i sued by the board of Jq ed. . . ... Application Approved B71rthe 1�_ e.--.... •-••-•••--•---------------------------------••-•........._..----•• •-----... = ---------- Date Application Disapproved following reasons------------------•-•--...............---...-•-------------------------------------------.....---------....--•--- --------------•------------...•••••••-•-----••-••-••••---••-•-----------.....••-----•----.......••-••-•--•-•..............-•--•-•----••------•-------•--•----•-••--•••-- ••--•--•---•---•---•---- Date PermitNo......................................................... Issued-...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF...........................................I......................................... Trrtif iratr of Toutplittnrr TH IS CERTIFY, That the Individual Sewa a Disposal System constructed ( � Repaired ( ) by--- ..... -aii .. .--•--••-••---•-•---•--.....•-•----•-.......--••••........................ at_ ' ... .......,, _. _ ........ ....--_-•�.......------.-----.................--- .. ... ............ has been ins a led in accordance with the provi - ns. f TI 5 o�hState Sanitary Co as se ' ed in the application for Disposal Works Construction No.--- �..-.- .-�............. dated .. : THE ISSUA1JCE.OF THIS CERTIFICATE SHALL NOT BE CONSTRUE AS A GUARANTEE THAT THE SYSTEM CTION SATISFACTORY.DATE......t�P/U /� - ................................................... Inspector••••-• ... .........---------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No ..... ........... FEE. ��.................... �i��ro�,�t. C�on�trnrttion �rrntit Permission isjbeKeby granted....... ...... ........... ............... to Construe ,� �r q it ( ndiv- a age- posal stem atNo ( !-------- ------ ". ...................................... ............... Street ;3-"--o as shown on the application for Disposal �V s Construction Permit N9 ............... ... ........................ Board of ealth DATE ..................................... FORM 1255 A. M. SULKIN, INC., BOSTON 3 LOCATION. SEWAGE PERMIT NO. -� t cat RA/ M0kAi4411j�b .4A1 VILLAGE i't�dr�S i L.S n. INSTALLER'S NAME i ADDRESS k. e BUILDER OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED lezoo r � l! . ,�'� -�� 3S . �)� , n A ya ✓:: s.� 1 q4' 1�-. t% - "by "7"Y b Ytl y x� Q• i l�cr ✓ t ryt�t, rk 1S�N i`t'� +A",F'd�r"• "t0111, l - /�1 sl v'+•r,�� i. bk y,}L'dl4 4 �'rlRY•} Eo� Iris/ { /\/. -` �� 45 > f7 G� � �•P q F `y T /k: Qtf-�. ti5 ' pcQc . ��r��x..a. elr'��'t p��.�� t11,,,� 'tqAMP- :�+5 _ r la k t�t//'�,► rig t �` sutty ,a� i ! ( �A e D) , ir7/p,�•,' ,t�}it+ al{'.' �,/'�'r WAil�p' Af \sj, r 4 R T LC. "'No 10951 n "� � ��.� A��Itl �".,k R ,rM� ��r ;�t �P 5�:�`•`�. .��Ft�S' t'r j F r.,.� � ��,(`lS��,,� . JS�ONA . ra .�� ♦ :� Yr' !�q ` s hF �4ii i �K.•� �7,.-t`4� `i"5 �� `{{k-J��t� - R• :'� t d� �.."..�'` O vie, Fll a fP "�5k •W ;..• t ) 4 x5.,T,. T /3_ 1•�. 'I I/I I I l� I I F - 4 rt i M1lt.. �1t! 341i 1"UQCAh,IT AJA%1); .P�Ta ..1�+J. C'S'1.��'CaFn1JUY-I�'(>•S�S-GL�V J�Y' Q Y � ,�� r�,c'. A ,.! !t "P�14'sIrY A 't'�',.,)!t` �' t /1L/. ' LEGEND �xr STING SPOT ELEVATION „ �►,�0,',� , �r�', ` aR mk �°. � , �t� �TIFIE®• 'PLOT. PLAN EXIS TIN 0 C0NTOUR rtmialtED SPOT E�LEVAT:I(ON yr .J III ISHED VOLT®V I ��7 5tt! 4 t �4i Fi Y ti Lil{} t.`� �( .Al i;5' �•G r f ate` �� u. F F �M OVER$ BOARD- OR^ H!A YT S E AOEN os �� ,#� CA`LEsi/ ' —3D» DATE�'6/Z3f�3 f 69* E'MGI�IE'Ell~lN�; 03T�.t �,,� ,�iH��o� , swGElf't'11FY =?HAT 'THE PROPOSED: 0lS�TEAE REOISTE Edf E�' ,'BiIL``•d`m -, SHOWN ON THIS PLAN lY�'L "COMFORM& TO THE ZONING ' LAWS �� bLIRV: •` �i�� F' � rOfi, SAfRNS.TA® E, qS3. Ex cep r s 1" "?'1`•2 M AI N $TR E ET F `' a �� O�Ii,BY.�'� 1 M 1 S x�)iCYtia�E :r a i irPt t r 'V� H t;�MA3SP VAM :0. LAND SUf?V,ErOA Np-r'F : /P� EITHER T.5lF S�PTIC TANK OR i s 20 FT_ POI/dt ?_EAGX/.vG P/T ,4.4E MORE TNA:•1 BELOW �/A M,E TER CONCR 6 T� CO YER !6 P7►.' /•0/A/ SfdALL 60 41.40U6,g7' TO 4,TA O.E.`-+,Y EXT,E'.4 t • CQJyCJet�TB "PYC P/Pe hrEAVy CAST IRON CO✓�.4 5'h/ALL 3c ✓SE.� .H/N. P/TCN /F/lV O W— R1 v 4 Y t Z,O COYER.S PER FT. i S 'r- 2 �• MAN. GONC,tZwTE _ '. .�.. i 2•LAYER ` tRaAf �lPi� 3� , 1. o�L. � �• • • e • •.• • ► ®• yyASHPO STfNE � MIA. prTl� TA/W O/ST. e • • • • • • • e 'PAfR FT SE BOX 1 • . e 1 • • . e _ ` e • s1 • 34•- l �2 �-v'Lx,�r . • • • • • DgPTiI • • e e. W�4StlED STDHE �* s 3 • e. • • • e • • / • o PRECA.S T SEEPAGE fir . r v`_, d� g l7i>L //n�Y • P/7 OR zv4ll .. 6 fr. pIAM. t}ItYERT a4T Blit/tDlNQr 8 - t s - t O.G41►f. C�SFF TABULATION} L 714ANC M °gFpTIG T.ill��C /a GRD�JN� Av P44TER TitBL� - r /1iIlFT DISTie%4� � ' .3�CT/ - T O�jDI�_Rl�lrT/®1� .$ �3 ��7 aIS 41�� • ..SlrA l-E. cL= 54.9 OJMENJl�iI16. . :be ,o.�i-t_ • -... is �' 0 t��eSEuT '. jV .E a DS/ff11r-�1 T°lel�l DI�yl�/1/$tON G F�' NUMBER DFV®IEL�ROOI�pS ' '%3 SKr ,ten„� LOG E :. a4RQAGEDJ3.POSAL UX/T_— SD/aL 7' TdTAt E�I/vysTEO FLAW 3 3 y G.4,L1AAY $OIL TEST A/ SOIL 7WST02 - Lr[EY. 9Y.p ,0�9T� OF sOIL TEST',.. ,M&,MBE.P � 40ACX/N6 P/7M L.___ S/OE LEACHING PFJ't P/T S-S4 I'T U - I RESULTS iV/T/NR35ED dY BOTTOM PEMCOlAT LICNlN<t PER I®N RATE / Ml/+�INGN r.;: r G PERCOLATION RATE/�2 �.f_ �. 1�!I N,f/INCH TorAc cE�acrl/V6 AREAU y so. iT 4- C'//>N6 ARE. SQ. FT. ,QE.5-CIT �E LEA OF t1k OF Ills\ P� 4ss�e C'z--14 >_ No. 10951 n EL D RE'f GE ENCrI NFFR/NG CO,INC. ,L `;r: : J 7/2 "A11Y ST. i/YlgA1V'S. ,4-fA11: ►�TB~ p� ��FSSiON��a�\`/ ® Na GROtINJ kV,47,eR ArNC0UiY7FR50 CL/EItT: ! �. ;y 40 SO Q GRO UNO LSrATER.AT �LEV, ✓O® NO.• S-3 + i+ �: SHEET_..O