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Home My WebLink About0125 ALTHEA DRIVE - Health /aS A dheo Wv' � i I s BUSINESS SOURCE FOe FddM 17�i25 Fs ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...............w y.......OF...... 5 Appliratiura for Biipu,s al Works Tontitrurtiun "amit Application is hereby made for a Permit to Construct (t—) or Repair ( ) an Individual Sewage Disposal System at: Lo tion Address or Lot No. .. o y D..J... T................................................ . ....e! ............. ...................................................... Owner Address •.................... ....... �.................................................. . .................................................................................................. Installer Address / S� d Type of Building Size .........Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (� Other—Type of Building ............................ No. of persons............................ Showers — Cafeteria A4 Other fixtures -----••-•---------------•-----•. W Design Flow...............5.........................gallons per person per day. Total daily flow... ..........: `..........I...._....gallons. WSeptic Tank—Liquid capacity sOj2..gallons Length Width.. Diameter................ Depth.�.'8�.. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit,No..................... Diameter.......?_z...... Depth below inlet......'`— Total leaching area._�0— ..sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 0'4 Percolation Test Results Performed by__..�►.I.. `.zG�L--------- ........... Date...14 ��_. 0-4 Test Pit No. I...4. ...minutes per inch Depth of Test Pit... _.. Depth to ground water... ".............. . Test Pit No. 2...15�`...minutes per inch Depth of Test Pit...e .... Depth to ground water........................ x O Description of Soil-•-------•----G.. -36..._.. �.. Sv3�-SoiG 36 � ��yNG -- •--•----------------------------------- -- .r xS..G ......SAD.--••----�� / i31_G�------------------•----------•------------•-••------------•------.----------------•----••--•--•----------- U W ----•••---•--------------------------------------------------------•--------•----------•---------------• ----------------L— N' C CQS VNature of Repairs or Alterations—answer when ap licable-_____--�5 )........... .. . ........ ....................:...... .�?. b �. 5� _.... ��.... L - `�`---moo,-a--( ....-p�.....--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal S stem.in accordance with the provisions of TITI.�. 5 of the State Sanitary Code— e ndersigned further a ees t to place the system in operation until a Certificate of Compliance has bee • ue b t rd health Signe ... Date Application Approved By. ------ --•-- Date Application Disapproved for the following reasons:................................................... .......................................................... .............................•---•-••-....--•-------------•••-••-....-•--••-•----•----•--•...---------•-----•----------•----•---•-----------•--------•-•-••--•-•••--•----•---------------•--•----••-••-- Date PermitNo........ ----------------- Issued-....................................................... Date e � - No' .. .. : ! .. . -.i ............ I . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -.............. .'t�.......OF...... r'�7 ................................................. Apphratiun for Diipuual Works Tnnuirnr#inn "Prntit Application is hereby made for a Permit to Construct (!- )' or Repair ( ) an Individual Sewage Disposal System at: _ ....:...........__................................._.......-----------••--•.........-•-----•--•- -----.......-•-•-•........._.......-••--...•-••-•••••-•--•--------...._.......----••••....._...__. 7-� Location Address or Lot No. Owner Address a ?. / .................................................. ................................................... Installer Address U Type of Building � Size Lot........,..................Sq. feet 4 Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ('--I Other—Type T e of Building No. of ersons____________________________ Showers � YP g --------•----•-------------- P ( ) — Cafeteria ( ) dOther fixtures -------•---•--•-•----•--------------------•--•--------._...--•----------------•----------•--...•.-•-•-•---••--------•-•-•----__....---••-•--......._.. W Design Flow_______________53_.__..........______.gallons per person per day. Total daily flow_.__._.__.____''_: -c'?_.....__._......__gallons. WSeptic Tank—Liquid capacity/ gallons Length__- ._._ Width............. Diameter________________ Depth__S.......... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.........!-_------- Diameter.......1 z_......... Depth below inlet......S......... Total leaching area._GOB.Z-.sq. ft. Z Other Distribution box ( ) Dosing tank '-' Percolation Test Results Performed by....Le?.w AA-Ze&—?L a ---/ -.................................................. Dae_. b/--- -r--•---- -•-•------- Test Pit No. 1.._�.4:___minutes per inch Depth of Test Pit__.. �__. Depth to ground water...._............... Test Pit No. 2...L.`_._minutes per inch Depth of Test Pit____ _._.. Depth to ground water-----................ ..................................:.......................................................................................................................... O Description of Soil U"_.-•% - a.�rs':? 5�>j_-�ai Se, "•-/� '" �E D yin/G- co U ....................... ......................................�---••----- -- ------------•-----._...------....---•--•-----••-•-•-------_..-•-----•-••------------•--....•---.......__....•...-•-- UW -------....- =,= Nature of Repairs or Alterations Answer when ap >cable • --�£' 1T11� �^ �... '�`!�� Agreement: ' The undersigned agrees to install the aforedescribed Individual Sewage Disposal tem in accordance with the provisions of TAITI1 5 of the State Sanitary Code— ersigned further ages adt to lace the system in P Y operation until a Certificate of Compliance has bee e ealth— Signed.. = ..... . .. Date Application Approved BY•---•--__,V_,.��_ --G--.---f.....--•--d-..•---_•--...::::.......•-----.............--•--•-•----•-- ........ t,t�?./_��....r�...._ Application Disapproved for the following reasons-------------•-----•-•----•-•-•--•--------------------...-------••-----------•---•--------••••-•_--•-•.._._...-- --•••-•---------•---•-•--•-•................•-----••-•-------•-------------•--------------....-----•-••--••-••••-••----------•---...•--•------------•••----------•...--•--••-•-...-•---••--••-------•-•- Date PermitNo......... t- --..... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................... !....OF......... ................. )1.3G '.................._..... TPrtif iratr of ToutplianP THIS IS TO CER,6IFY, That tie Individual Sewage Disposal System constructed ( c�-or Repaired ( ) bY•--------••----------------- .....__.. R-.��G '-..-•.....--•-•-....--------------•-•--------•-^---------.:::..---------•----•-------......---------...----•---•---... r^e Installer at. ----- -•---••------------------------------•-------.._...--------•••----•-••------•---•. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.__n ....__L�_�—y_-.__...... dated......_.y�1��__________________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE _ SYSTEM WILL FUN TION SATISFACTORY. DATE............. .................................. Inspector.' ------------- ..................................... THE COMMONWEALTH OF MASSACHUSETTSLes intAok Lm�iACX'( BOARD OF HEALTH WN.....0F........v/ ✓4NSTi�t�L L— .. No....... _�.^ ' FEE........................ C�1*,4i+-,—, ,.� 't f n��t nrk nnu�rnr#inn Prmt� Permissionis hereby granted...... .....—)...........---1............................................................................................. to Construct ( 1,� or Repair ( ) an Individual Sewage Disposal System atNo.......... ------- _ e;,•••---�.,0-- -------•-•-•-•---•----•-------------••-•-------__-------•-•--__._-•----•-•-••-- Street as shown on the application for Disposal Works Construction Permit No..................... Dated...... .. _ D AT A Board of Health IN 0. -----------—----------------------- ----------------- FORM 1255NA. M. JULKIN, INC., BOSTON r SATE LOCATION ;BA�¢wS7!AB �cu�stis�¢��a� N SCALE . . 4'.' . . , DATE FE4- / /9B6 PLAN REFERENCE . .&.<r.. '?7 -'Z-I- . . syo�..►• .�/v. ,.��.tic., �o . . . . . . o9 ACATar la I W I QeseRvc is 9C' Pr Ar p [aacu ', .2�a�zvt Sid. 9X a I v-'_r� �� }F �-' _ ' 0— ST IS' 86 4� /4s sip FT. i N N OF PADE. <\ ^ KELLEY "D No. 26100 r, Z�Ac a J P.-rcNt`� - A�7'iTiwv�'T� Wej-7 Z�oF"e-E L. . TOP OF FOUNDATION _ CONCRETE COVER CONCRETE COVERS 4"CAST IRON f2" • OR SCHEDULE 4d 12"MAX. ' P.V.C. PIPE 4��SCHEDULE 40 P.V.C.(ONLY) ' PITCH 1/4"PER. PIPE-.MIN. LEACH PITCH 1/4"PER.FT. PIT PRECAST e � -� LEACHING •' NVERT � ..�� '•• EL. INVERT INVERT/ INxZRT : . ; PIT OR . , SEPTIC TANK DIST. 77 W S;� EQUIV. INVERT EL..94.. . .. BOX EL......... ' : >_ . . /S�o GAL. INVERT :86„ INVERT 3/4"TO I Vf 0, EL9zoo :' LL� WASHED STONE ,•, —►1 PROFILE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE SOIL LOG WITNESSED BY : DATE .�O�Z3/8S 'TIME .`�4-7 . . . . . . BOARD OF HEALTH TEST HOLE I TEST HOLE 2 . ,Lo W, W4jZG6 Z. 2;yc., , ENGINEER ELEV... g•SAP. . . . ELEV. .9. P, 9. . LoA�`s � � Lest d Sao_so�� . . . . . . . DESIGN DATA : 3[ 3� �Z.9Z.00 -e'z• 9¢.00 NUMBER OF BEDROOMS . . .¢. . . . . . . . . . , TOTAL ESTIMATED FLOW . . ./ GALLONS/DAY ry 5167 y BOTTOM LEACHING AREA . . . . . . . $0.FT./PIT/4•t�R D. .Sly o -SA•,v,° /88,S SIDE LEACHING AREA . . : . . . : . SO.FT./PIT/377G,RD. GARBAGE DISPOSAL YIF7 : ..(50% AREA INCREASE) TOTAL LEACHING AREA , .Co3•,?r. . . SQ.FT �z. B3.00 /44" tz.BS.00 PERCOLATION RATE 1.A ?� .'a'!?. MIN/INCH LEACHING AREA PER PERCOLATION RATE .9` Z„ SQ.FT./,c,P,D, !!?..WATER ENCOUNTERED , , NUMBER OF LEACHING PITS .TWo A/73 IV17TV. . . , APPROVED . .. . . . . . . . . . . BOARD OF HEALTH • • A'fC; • D�'' DATE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AGENT OR INSPECTOR EDINA LoT 2 S ocn H, cn vo. 26100 s �C1STE'��//�" �01STS: L L SO AM PETITIONER . . . . . . . . . . . . . . ,0,c @0 * � . ,e EWAGf 'PERMIT. , L1,7 L a E AZ.OUSUNS IMP No. . �� PARCEL NO.:IR i S A LL# 'S £ A �«iE A'i ) RE3Sf � K1 € L- R OWN Eve • 'Y. jj �� ,0ATE PERMOT 15S .i -Es , Oar ';±