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HomeMy WebLinkAbout0098 MOCKINGBIRD LANE - Health 98 MOCKINGBIRD LANE, M. MILLS ,- ---- -- - A= 013 037 i p TOWN OF BARNSTABLE ✓ LOCATION /5//4l1T SEWAGE # / Z::�3,r ,VILLAGE_ _ �WY'5W5 %,��ASSESSOR'S MAP & LOTQ/3—cl)3 INSTALLER'S NAME&PHONE NO. /�JDIo1�i�Llf//.yJ`, SEPTIC TANK CAPACITY LEACHING FACILITY: (type)ACKZ_,W_ �J J(size) r6 ?e."'Xa r NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: 1/ Z 3`d/ COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and,Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist J on site or within 200 feet of leaching facility) Feet Edge of,Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by d�� M _ ��� �. /� �_ _� %9 f� '. � ���. ��� i l �• 3i �i .;c 7 b � ;o` l��j� p��� 4G 6 �� No. o�00 i t��Q Fee 5 /// THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓/ PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipprtcation for 33tgpo!6a1 *p5tem Con5tructton Permit Application for a Permit to Construct( )Repair(lam)Upgrade( )Abandon( ) O Complete System Fe�dividual Components Location Address or Lot No. ��G J�,N p1j�� �, Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. jg 'Co �r 7 /-�, ��' Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder(110 Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures 2 Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 'r3 it DD® !p' Type of S.A.S. Description of Soil 40,it✓e.,r 2- Nature of Repairs or Alterations(Answer when applicable) ,4—)'7k Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued thi B and o Health. /® Signed Date Application Approved by Date / a3 Application Disapproved for the following reasons Permit No. 700 ''Cam Date Issued 1 1a-3 / ® J No. ` U�O Fee S THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Digogaf *pgtem Conmruction Permit Application for a Permit to Construct( )Repair(I/)Upgrade( )Abandon( ) ❑Complete System LJ'Individual Components Location Address or Lot No. /AEG J��N p6ir �/J Owner's'sj Name,Address and Tel.No, Assessor's Map/Parcel /��`!,!'`���Jc / /j� (!�/ al "I tl Installer's Name,Address,and Tel.No. Designer's;Name,Address and Tel.No. I3o�'�`G��iCorsT 77i-?,Ky Type of Building: Dwelling' No.of Bedrooms Lot Size sq.ft. Garbage Grinder(/d Other ti Type of Building A e5/ . K-60No. of Persons Showers( ) Cafeteria( ) Other Fixtures ��1 Design Flow ��® gallons per day. Calculated daily flow J�3o gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank le �+js'2"/f19 /ODl�iaa' Type of S.A.S. Description of Soil lev 3"Z Nature of Repairs or Alterations(Answer when applicable) �1 ��' Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued thi B and of Health. _ Signed Date Application Approved by_ I(,O h CiA.� Date a3 a Application Disapproved for the following reasons a Permit No. 7001 ' Date Issued l 103 ! O THE COMMONWEALTH OF MASSACHUSETTS �f — BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERPFY, that the On-site Se age Disposal System Constructed( )Repaired ( ) Upgraded.( ) Abandond )b ,C%'�r 4d I/ at / ©, /!7has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. o_CQO)-OSS dated rL,73)O Installer Designer ; The issuance f this permit shall of be construed as a guarantee that the s,ys� ill function asdesrgne " Date lt�l� Inspectors/'� o ---------------------------------- No. �o` y G/3 0 3? Fee ISO THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Digpogar *pgtem Congtruction Permit Permission is hereby granted to Construct( )R pair(✓)Upgrade( )Abandon( ) System located at "'dC�!/?9 ��p /4 . I'S�`Dl9S �'I///_.S and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date: 1a 3 o I Approved by ' 'i /46/ I b i I I i o-�a� r ` A" NOTICE: This Form Is To Bets — For the Repair Of wiled Sep-tic Systems. Only. _ aRTIFICATION OF SKETCH AND WORKS CONSTRIICTION FERMTT APPLICATION FOR A DISPOSAL OUT DESIGNED FLANS) t4!6�erefl certify that th Y C�rory e application for disposal works construction permit signed by me dated /l/Qla/ concerning the Property located at ��� d'yl�G�l��,air��, ��/Sf�,p��ye�s all of the following criteria:. V The failed system is connected to a residential dwelling o 'v nt . There are no commercial or business uses associated with the dweiling. /7ne soil is c assined as CUSS I and the oercoiatianat_ is .h e ' less - an or egLai .o 5 minutes per inch ''here are no wetlands wifttin 10o feet of me proposed septic systcm 7-here are no private wP,.:is within,t c0 e`t of the nrot used se^,,tic r s se^t. here is no inc.ease in flow and/or chain;_in rse nroocsed +' in ere are no variances.requested or needed The bottom of the proposed leaching facility will not be located less thin Eve feet above the ma.Yimum adjusted groundwater table--'Vration. [Adjust the groundwater able.using the?timntor method when applicable]. Y the S.A.S. will be located with 250 feet of any vegetated wetiands . the bottom of the leaching facility will not be Iocated less than fourteen(14)feet xim above the mamu adjustedsea groundwater table elevation, Please.complete the following. A) Top of Ground Surface Elevation(using GIS information) �✓ • B) G.W.Elevation +the MAX iftgh G.W.Adjusanent DU ENCE BETWEEN A and B SIGNED DATE: 5 - [Sk mh proposed plan,of system on back]. ¢beam folder:cat �f.-,�Y h'L�, -�^" �-raYa. �h2y��"`y L'"' �`f'rc�h��yc-' J4x.: k T�,.1 i .�'S tiS'3 )1'�,.. �t ".G:61'+.}�t-.S tl •Fr-�+ �y a S y 'iy I TOWN OF BARNSTABLE j LOCATION G r Ak:I ,Iel✓j ,I51401l-!, SEWAGE # i VILLAGE Al-W5 72W5 ASSESSOR'S MAP & LOTS�3 D� INSTALLER'S NAME&.PHONE NO. &/' lol�/ il,� SEPTIC TANK CAPACITY /ZVO 94�� (ryPe iE. ( ... ) LEACfIING'F.ACILITY. 1-a �� rcf size /4 y�'J d'x NO.OF BEDROOMS .3 BUILDER OR OWNER PERMITDATE: 11Z.3(4�9/ COMPLIANCE- DATE: . . Separation Distance Between the. Mazimum,Adjusted Groundwater Table and Bottom of Leaching Facility ; Feet Private Water Supply Well and,Leaching Facility (If any wells exist P on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility.(if any wetlands:exist. I, within 300 feet of leaching facility) Feet Furnished by �c .77 i r a4 _ 21 e - y MTIFIED SEPTIC SYSTEM REPORT. RECEIVED LOCATION MAY 3 1995 HEALTFI DEPT 98 MOCKINGBIRD LANE TOWN OF BARNSTABLE MARSTONS MILLS, MA 02648 MAP 013 PARCEL 037 LOT 107 PREPARED FOR SELLER MR . DANA MOHLER-FARIA 98 MOCKINGBIRD LANE MARSTONS MILLS, MA 02648 BUYER MR. & MRS . GREGORY BARJIAN 293 EAST COUNTY RD RUTLAND, MA 01543-2040 PREPARED BY HILLIARD HILLER, JR. 41 MAPLE AVE CENTERVILLE, MA 02601 508-778-1472 r 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Address of property y8 MO�Kl�6 /.Q� Li9�/E owner ' s name Date of Inspection PART A CHECKLIST Check if the following have been done: Pumping information was requested of the owner, occupant, and Board. of Health. 1� None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. _ r/ The site was inspected for signs of breakout. � All system components, �cluding the SAS, have been located on the site. !/ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. 4/ The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. r/ The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of SSDS . I I � 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential 3 number of bedrooms _ 3 number of current residents -No garbage grinder, yes or no YES laundry connected to system, yes or no _,(ice seasonal use, yes or no If nonresidential , calculated flow: Water meter readings, if available: /99V Last date of occupancy GENERAL INFORMATION Pumping records and source of information: 1_ s System pumped as part of inspection, yes or no if yes, volume pumped —�Gr�� �,,gL Reason for pumping : Type of system i/ Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) Other. (explain) Approximate age of all components. Date installed, if known. Source of :information: v�ii�GsfI � ss�/. 0 9�7AS' _moo Sewage odors detected when arriving at the site, yes or no Y i 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK:_/---" (locate on site plan) depth below grade: material of construction: concrete metal FRP other(explain) dimensions:_ sludge depth distance from top of sludge to bottom of outlet tee or baffle S3•• scum thickness ,8_ distance from top of scum to top of outlet tee or baffle Gjs ' distance from bottom of scum to bottom of outlet tee or baffle Comments: ( recommendation for pumping, condition of inlet and Outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, recommendations for repairs, etc. ) DISTRIBUTION BOX:__ ( locate on site plan) YZ depth of liquid level above outlet invert Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, recommendation for repairs, etc. ) Tom/ ' /i_ 6d�S S ��Tch' h`i _i7_Gc2 sEo 7&Z D G�UC' A-t=)T' ovTG_4-T PUMP CHAMBER: T�i4i' ��T2 /c'GdccrA 15, (locate on site plan) Pumps in working order, yes or no Comments : (note condition of pump chamber, condition of pumps and appurtenances, recommendations for maintenance or repairs, etc. ) 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : L,­� (locate on site plan, if possible ; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type leaching pits and number—le uv=-m-rg—vz rc3-airRy erS an'd—nu-lttZfC''� � a l l e r i e s-and- rt e r t r e neh-e� , twin ber, length- Comments: (note condition of soil , signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs, etc. ) lH�/1� l�Ht �/4y/.D /,y Thy f�/7" �3� ]��`7�'/�,� V►/Ei1,� �S'�y.� .9G lhoTilL.�r lf�f�+T TH-r CESSPOOLS (locate on site plan) : number and configuration depth-top of liquid to inlet invert depth of solids layer depth of scum layer dimensions of cesspool materials of construction indication of groundwater inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil , signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs, etc. ). PRIVY : (Locate on site plan) materials of construction dimensions _ depth of solids Comments : (note condition of soil , signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs, etc. ) I 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100 ' c� I Cris � I �a Cry W� 4J � v W= � I I I I i I _9 S DEPTH TO GRQUNDWATER g� 7 S`9 3 d 30� depth to groundwater - method of determination or approximation: T1iGe�19J�ic T UZ ��s�s o Jos r a53 �orrsAC 6 7 o PIT r fA54/L + P GouL/� 12 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined" , explain why not) _V Backup of sewage into facility? Discharge_._ of and 'p ing of effluent to the surface. of the ground or surface waters? _Y ' Static liquid level in the distribution box above outlet invert? B&-r tout i o fI A1T6,41 /t-' _/t/ Liquid depth in cesspool <6" below invert or available volume< 1/2 day flow? Required pumping 4 times or more in the last year? number of times pumped Septic tangy: is metal? cracked? structurally unsound? substantial infiltration? .substantial exfiltration? "tank failure imminent? Is .any portion of the SAS, cesspool or privy: V below the high groundwater elevation? _ V within 50 feet of a surface water? V within. 100 feet of a surface water supply or tributary to a surface water supply? within a Zone I of a public well.? A-" within 50 feet of a bordering vegetated wetland or salt marsh (cesspools and privies only, not the SAS) ? within 50 feet of a private water supply well? k1 Less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analysi for- coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. r 13 • SUDSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART D CERTIFICATION Name of Inspector Company Name Company Address r?o dpX sD G Coi-tifi.cation Statement 1 ccrtif:y that I have personally inspected the sewage disposal system at this address and that the information reported is true, accurate and complete as of the time of inspection. The inspection was performed and .Iny rocommendati.ons reg,ardinq upgrade, maintenance and repair are consistent with my training and experience in the proper function and Ilk,Ill.it:.cnalice of on-site sewage disposal systems. Check one : I hIIve not found ZIny information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. 1 11lIve determined that the system fails to protect public health and fihe environment Is dcf.i.ned in 310 CMR 1.5 . 303 . The b(Isis for this determination is provided in the FAILURE CRITERIA section of this form. tnspecto.r. ' s Signature W44-i c I r i c�i nn 1 to sy::,t.cm owner. HLlyer ( if applicable) Appi oviny Muthur.i.ty r KEY NUMBER <8131 > NAME <MOHLER-FARIA, DANA A > B-C 1 B-C 2 B-C 3 B-C 4 STREET 98 MOCKINGBIRD LANE CITY MARSTONS MILLS ST MA ZIP 02648-1301 REF 1 REF 2 PHONE ( ) - REF 3 REF 4 METER NO. < 7652> DATE READING CONS STREET <MOCKINGBIRD LN NO. 98> 12/31/94 942 jcc-74 CITY MM A L107 ST LOC 06/30/94 868 _ 31 PHONE ( 508 ) 420-3312 12/31/93 837 �y 123 06/30/93 714 S" 22 ROUTE NUMBER 05 12/31/92 692 83 SERVICE DATE 09/17/84 06/30/92 609 � 30 METER DATE 10/03/84 12/31/91 579 � 50 CAPACITY 7 06/30/91 529 � 25 STYLE T10 r SIZE 1 RATE SCHEDULE KEY PIT PLASTIC X NOTE RR RIGHT SIDS ADDITIONAL CONS 0 ALTERNATE MIN 0 1 I� LOCATION , SEWAGE PERMIT `N0. VILLAGE AA INST LLERIS NAME A ADD ESS R U DE R OR OW13ER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED 0 v 3 � 1 V/ No.............. /0 ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH., .................. ...................OF.....------................_ ........ ................................... Appliration for Uhipasal Workri Tomitrurtion "punfit Application is hereby made for a Permit to Construct ()0 or Repair an Individual Sewage Disposal System at: .............. ..............................kt..,&r.............................................. Location-Address or Lot No. .................................... ................................................................................................. Owner Address ......................................................................... .................................................................................................. Installer Address Type of Building Size Lot.2_0)_309........Sq. feet U Dwelling—No. of Bedrooms......-2................................Expansion Attic Garbage Grinder Other—Type of Building ------------------_------- No. of persons.....................__.__.. Showers,.(�,; — Cafeteria Pa Other fixtures ........................................................................................................... ;jX__1 .111.1......------------ --------------------- Design Flow.........11.4�..........................gallons per person per day. Total daily flow.......4.yr ......... •_:�f,._gallons. P4 Septic Tank—Liquid capacityVAagallons Length,8_'6.'.... Width-__ rn Diaeter__A�....... I3iptfi..5..1. W r Disposal Trench—No..................... Width.._................. Total Length.__................. Total leaching area....................sq. f t. Seepage Pit No......./----------- Diameter.._.__AO.-___-_- Depth below inlet....../a.'*......"Nbial leaching area..24.7....sq. f t. Z Other Distribution box Dosing tank V6 Percolation Test Results Performed .1 - 717-A& Date---6 &-------/g _/ Test Pit No. 1,42 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.................. ......................... Description ............................. ....................................................................................................... 0 ..7� of Soil_&-- .2..... . .......... L U ......................................................................................................................................................................................................... W x ........................................................................................................................................................................................................ U Nature of Repairs or Alterations—Answer when applicable.............................................................................................. ........................................................................................................................................................................................................ Azreemert: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with e provisions of TII TAIZ- 5 of the State Sanitary Code— The undersigned further agrees not to place the system in 0 ati 11 rti e of Compliance has been issued by the board of hailth. igned....... ......................................... .......................... --- ...... ................................. ............................ .... yy ..> V.............. li 'on Approve Date plication Disapprove or t e following reasons:............................................................................................................... ........................................................................................................................................................................................................ Date PermitNo......................................................... Issued....................................................... Date No....l� /--_(//0 Fus... ............_ I` v THE COMMONWEALTH OF MASSACHUSETTS f» BOARD OF HEALTH ........................................-OF.............-..-......................----.------------------._.-._._................. ApplirFatiun for Eliipu,i al Works Tunitrnrtiun rumit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: =---•---------- --•------------------------'fit - ° ............................................... Location-Address or Lot No. L!C.7./ :! .....................•--••---._.............. Owner Address W Installer Address Type of Building Size Lot_ _3jZ2.Q_________Sq. feet 14 Dwelling—No. of Bedrooms......._ ________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures --------------------------•-•• -••--- ••••. -._..._ W Design Flow.........11.:2............................gallons per'persan per day. Total daily flow______4`1_�_______.____________________gallons. WSeptic Tank—Liquid capacity i2.: ?_gallons Length:E?`�-,,�?..... Width.__'`_`/'?_ Diameter________________ Depth_.--,,--- x Disposal Trench—No_____________________ Width.................... Total Length.....................Total leaching area....................sq. ft. Seepage Pit No-------/`_-_-_______ Diameter......Z_2.___.._. Depth below inlet......:�........... Total leaching area..4.%' ....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by..61(),,'z�i:--Z-."I!e:-I!&.r=1.1_i?,+__f?SS���__,_�J+?�___ Date... ............... Test Pit No. L__a_=__----minutes per inch Depth of Test .... Depth to ground"water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •----•••.--------,•-------..........................................................•-------....----......................................................... , D Description of Soil_/J__::`. .�._%cy7 ..... Sf?sa:. ..��:'./-•-----' -' %� � '......................�- _._ x 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 th provisions of TIT1E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in ati it rti to of Compliance has been issued by the board of health. .,' igned- `Dat�j-- A li tion Approlved�Byy ..............................••.._..•----•-- ---� ------ Date PPlieation Disapprove 'f or t e following reasons:------------------------------------------------------•---------------.--.--------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Date PermitNo.......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH"- .........................................OF..................-.........................................._....................... /THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed o'r'Repaired ( ) t `,cL_ .... 7. , has been installed in accordance wit provisions of 11TIE 5 f The State Sanitary Cade as described in the application for Disposal Works Cd uction Permit No. _ __' �0_.............. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................................7`!:1........-----• Inspector.................... =-2�E.................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........:...............................OF........_.....-...._._.._.._.....__.--...----.---....••-...-•---...--......_-••---_.. G� No..................... FEE........................ Napo urk� kull rnr#fiun rrnti� Permission is granted_: -! �______________________, ..... _. to Construct •�~� an Indiv��. 1 Se age Di al System - reet as shown on the application for Disposal Works Co st ction Permit No.________r_ ._____ ated........................................... ............................: •---••---- ............................................. I = Board of Health DATE------ - --•----- f- ' FORM 1255 HOSES & WARREN, INC., PUBLISHERS �L (3 - d3? Iv^ LOCATION S111_A-"-PMRMIT N0. - -e � v VIL`LACE MAA cl N Si LL. ER'S NAME i ADD ESS 'R U DER OR OWNER DATE PERMIT ISSUED � ��� DATE COMPLIANCE ISSUED 1� 7�7� _77 7 m IN.6P :'.OF..f'F0(JND. V T�N AO : FT � �, 4. S dH'. �40-- PV CLEAN SA b 0VE Rs' --MIN.; PITCH PIPIE' CONCRETE 1/8" p' ER FT. COVE R NAY �� ' 2" LAYER, OF ':1RON 12--,,MAX PIPE MI 'PITCH AoRr (/21, 'WA H b N. 6 STONE 6 1/41' �PER FT MAIE r;LOW LIN WA KE f3y A o. EL,.= .10b.1 --MIN. EL 99,E L. EL 99.1 -99.3 EL.= EL.= Ld > LOCATION MAP -BOX /4" 1/2" 'WASHED ' STONE c 0.0 U- 0 Ll PRECAST , LEA CHING EL.:e 'GAL , EQUIV. 7 BASIN OR SEPTI G -ANK GROUND WATER TABLE EL. PROFILE OF .97 0 /09 S E VVA-Ct DISPOSAL SYSTEM �NOT T DE�,SIG, OIL TEST S e v Ntj Rooms .. . _f�'S T I Zg DATE OF SOIL GARBAC- AL� UNIT sp()§, 99t 'IM'ATED FLOW WITNESSED BY Zf rACO-C TOTA IL ifS�% C H PERCOLATION R AT,E Z MIW/ 230 GAL./'DAY /12�11L.�/BR./DAY - OBSERVAT UIRED �,E-PTIC,�, :TAP 9-5 GAL. OBSERVATION HOLE I ON HOLE REQ . . .. ... K o­CAPACITY_ —ACTUAL TA N K. . . ... . . GAL. LEVATION =/o/-4 ELEVATION 1039 51.1t -OF �SEPTIC WIN v LEACHINQ�;�KEA REQUIREMENTS . ' SIDEWAQ L­ ARE G AL./'S.F,� A - GAL./S.F. L2 G UAPACITY. 'GAL. .t.EACHIN jBOT TOM .4- 81DEWALL).— _x fx P oi S UA CH 1 N G CA.,A C I T Y GAL 7, --,4 C,41 -Ir 92() -5 6 NOTES ALs -�'I.-ALL W&Y� HI AN' MATERI NFORM 4NS 0 D 2077 -'5 `:AND 'THE TOWN ,:.0 r D E'Q E� TITLF, F bo TO R REGULATIONS' . FOR SUBSURFACE DISPOSAL, ULES 3- OF ' . SANIJ&RX; SF-WAG _�_'SHALL:.-'BE -COMPLI-ANCE WITH �'.ZON , 2. IN G': IONS , BUILDING SETBACK �OER ' BUILDING 'DE- ERM4 REGULATIONS: T 4ti[4-��b BUILDING �,INSPECTOR OR ILDING y BU INSPECTOR OR BUILDING COMMISSIONER E Comm MIN. FRONT - GRADES SHALL REMAIN' ESSENTIALLY. L 3�EXISJING NDs , FINA MIN. REAR SET13ACK :-.THE ',. AM MIN. SIDE S E TBACK. ' OF A BOARD Hb -'T'K PPROVED : AGENT DATE PROJECT LOCATION;,- Z07 APPLICANT : - 7 ER 3_ ­C14 45k DR.' BY �`LFGEND . SCALE' DATE, 00.10. EXISTING—., P OT.,,t L E VAT -V X JOB APPD. BY: RE IONS C 00 - ING �CONTO *tQ7 ' ' -:' I E M S'T UR, N ELE %ATION IS'. 0. C. FINAL _ �CO DR AWING" :SOIL L C REG. 'LAND $URVEYORS-REG. 5ANIURIAII/S T"M R 00 -NO.' R 0 HEARN ", INC. sr� o 4f "s TE PLA N ' 1348 ROUrE P 0. BOY 1263 D -OF E : SE4