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Home My WebLink About0061 BOULDER ROAD - Health _ BOULDER 1 _------- `x`'�"ram_ �; ,,. -_► No..-..................._ Fxs.... .. ............._ THE COMMONWEALTH OF MASSACHUSETTS BOARD F H A ......OF. 3 Appliratiou for llispviial Works Toustrurtilatt Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal. System at: G ^' /� Urf ocation -Addre t No. �'c; . _•C ..t1 /c .................................... .. e. cr S � _2 G 3 7........_ Owner Address Installer Address v Type of Building Size Lot.... .......... .....Sq. feet U Dwelling—No. of Bedrooms..........I.................. .._..Expansion Attic ( ) ' Garbage Grinder ( ) p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures -------------------------------- - ---.... W Design Flow ....�..�.�..�_�,gallons per person per day. Total daily flow............. 2. ....................gallons. WSeptic Tank—Liquid capacity_/k..gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—N . .................... Width .............. Total Length.................... Total leaching area..._._.____..___.JJ sq. ft. Seepage Pit No....... ......... Diameter..........Id.... Depth below nlet.._..�.......... Total leaching area.._�.�12_.sq. ft. Z Other Distribution box ( ) Dosing 4th ) G Percolation Test Results Performed by...... a ........... Date.A*, ._r�.-._l..l_7_�_... r Test-Pit No. 1._, .......minutes per inch Test it................... Depth to ground water............... r1;4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ........... r---•---- - O Description of Soil............a .... ........2 !.. --- -�-... IX x ----------P----------------------------•---------- �,R --•- ------....... .---....-- . -• --•---•-•---. --........---•-----•-=U UW ------------ ------------------------------------------------------1------------- ----------------•------------------------------------------------•-------•-------•------------••......---•------•---- Nature 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 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 byp, thee�bboard of health. Sig !? ..1.�_.K� '.................• ... Date Application Approved By........ . ..... .............6 -_--- --- _�_�3%.-.7. ._:. r Date Application Disapproved for the following reasons-...................... -.-•---•---•-•----------•----•......... 7 , Date <% Permit No---------------- ------•--- Issued.--- � Date No. FEB THE COMMONWEALTH OF MASSACHUSETTS BOARD F H ALT , ...............f4 a I to.......OF.. . ApplirFation for Dispoii al Works Tomitrnrtion Pumit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................_................... . •----•----•----••.._...._..._... .......... ....... lion re Add t No. . 01 AR ..................•----------... ,�1.,. °�ss,:...... . . . ......... Owner ddress W --• --- Installer Addresst Type of Building q Size Lot.......:....................Sq. feet Dwelling—No. of Bedrooms...._._...+ .Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ...... No. ofpersons............................ Showers � YP g ...................:.. -•-•---------- --�- ( ) - Cafeteria ( ) d Other fixtures _...._.. ----- W Design Flow' .............s�...i�._..........._gallons per person per day. Total daily flow............'► ::_.::..._..........gallons. W Septic Tank Li uid"ca acit . allons , Length .... Width................ Diameter.. ..... De P q P Y g g Ptll x Disposal Trench—N ..................... Width................... Total Length.................... Total leaching area......... sq. ft. Seepage Pit No........ _______.. Diameter.......... ..... Depth below 'nlet......w/......... Total leaching area... ft. Z Other Distribution box ( ). Dosing tank _: '-' Percolation Test Results ' Performed b ....... { Y - - -•�--- -------•-•-•--------------- Date.. ..,�` !(..�.�:.... Test Pit No. 1..4.)--:,.minutes per inch Depth f Test Pit .............. Depth to ground water ------------------ f� Test Pit No. 2.................minutes per inch Depth of Test Pit...........:......... Depth to ground water.......:................ D Description of Soil----........( ._"_ '" .-. .. :......�.. .................... U ...................••--....•-•••-----•-••••-----......------•.......---•--••-----•--•-•-•---......••----......•-•--••-•--•-•--•---•---•-•-••------•-•--•--•----••••••-••.........---•-•-•------•------.. w --------------------------------------------------------------•-------------•-------------------....----------------------------------------------------------------------------•-------•-•--•--•--..... U Nature 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 L p 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 .. � oard of health Siga_'... -------------•--- ' ----- Date Application Approved B Application Disapproved roved yor the ollowin 4reason ._. Date PP PP f f 9 s. ... ---••---....•--•-----•---••--•------••••-----••--•---•---•-•----••-•----•--•••......•------•------- ......................................................•.............................................•... ............................._.�_..�d -----••......__ ....... Date _ Permit No........................................................ Issued.... �'...................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD 9F HEALTH ............ 1 ....OF......... . .. '?..............................................:.... �rrtifiratr of Trrm#H anrr t THI TO CERTI , That the Individual Sewage Disposal System constructed ( or Repaired ( ) by fil&q; F ------•••- jl. �flf Ins Ilex •------•--•-- w, P •r . has been installed in accordance with the provisions of TI r of The State Sanitary Code as described In the `t'��i' truction Permit No....... application fors Disposal Works Con .......2., dated-.. r '... ••--- THE ISSUANCE OF THIS jCERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WlkL FUNCTION SATISFACTORY. 7 c DATE.....---- ,_. Inspector.....0_. ,r . THE COMMONWEALTH OF MASSA-CHUSETTS - WARD OF HEALTH r. w . 71 .,OF........ )4441%...a ................ rf'. No:: �: . ---.... "_ FEE......................... _ i r �arknrn rrmif ._ Permissionereby granted........------,--- �'�•-�•----• •--------------•---------------=•--•-----•-------......---...--•---.......------- to Constr ( )repair ( an dive f Sewag Di s sat S s 7�r Street as shown on the application for Disposal Vl-rorks Construction it N : :...r ....___ Dated.. /`.-.ram`'`0..._....._.... -• --- . ............................ ¢. 7 * Board of] �h tJ /� DATE.... ---=•---.----•-�•---�-�-•---•------------------•------............. • FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS TS-4o,ao CSJ ` !3 � Q'qj i'74, Nip / ! R o�c T w� o F B�i;zn/STAG E' l I '�ti:ros,o EDWARD E. KELLEY l t'aw I � O. AG UID, MASS. 02637 J s Bo� f�s�7uD SB' T11� t,E�l y EL i q 9l..o Pir NoTE"_ `c(,E"�,c}37ov,5 13�5ED en✓ f35.Srrr�e7� !7A'IiL/`j CERTI FI E0, PLOT PLAN LOCATION SCALE . �i_boo.'. . . . DATE ! 4.19�79. PLAN REFERENCE .4&7A/0. . .4.T. 4S . az I CERTIFY THAT THE 253,00 . , „4 SHOWN ON THIS PLA .,I . ON THE AROUND STATE` N<cAlIVA / .�vu7C AS SHOWN HERE T IT CONFORMS TO THE l SETBACK S OF THE TOWN OF WHEN CONSTRUCTED. DATE . PETITIONER: Ct,i`f'1<ICP /".5 REGISTERED LAND SURVEYOR L. TOP OF FOUNDATION CONCRETE COVER CONCRETE COVERS 0 4"CAST IRON �D1T ,'•• PIPE (OR 12��MAX. 12"MAX. 4"ORANGEBURG(OR EQUIV.) EQUIV.)- MIN. PIPE- MIN. LEACH PITCH 1/4"PER. PITCH 1/4"PER.FT PIT PRECAST a' IN L • Q LEACHING :.,.. ` o EL...�_ZS.. INVERT INVERT o . e•; PIT OR SEPTIC TANK EC• 9e.3G BOX EL 89,`./• >_ EQUIV. o INVERT -�. 0: •�• /.000 . .. GAL. INVERT •, �a INVERT ;• W W 0: ::; 3/4"TO I I/2 � EL 89 7$ EL B8.3o ;. u- 0 WASHED ` I W �' STONE o ° /a `• T 61 DIA. -i-� T o . . �---- /D i DIA.----+-1 NaA/E PROF1 LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE 1%P'R5"%PE LIMI n A R SOIL LOG WITNESSED BY : DATE 77 TIME. BOARD OF HEALTH TEST HOLE I TEST HOLE: 2 T�/aaa.9,s �; , u /•� PE; ENGINEER ELEV. .88,1P. . . ELEV. .V-a-P. . . woob[oAm7 / Woob�ps ,r ' 6" c„ DESIGN DATA 30" ��'`' 3oi NUMBER OF BEDROOMS 3. . . . TOTAL ESTIMATED FLOW '3a. . GALLONS/DAY 7nr �f�icrr� BOTTOM LEACHING AREA 7BS* . . SQ.FT,/PIT Ss++vD qq�n SIDE LEACHING AREA . . 1BB. � . . SQ.FT./ PIT GARBAGE DISPOSAL ` (50% AREA INCREASE) TOTAL LEACHING AREA . .7-4 7 P.O.. . SQ.FT PERCOLATION RATE LDS T�Aw Vic. MIN/INCH LEACHING AREA PER PERCOLATION RATE .'�30.. SQ.FT. N?.WATER ENCOUNTERED NUMBER OF LEACHING PITS 1 P/T. M�r.M.. Two• • /:�'4 j"OF 7DN�" N O A44 .S/DFS, a IS.--I T� S V �/- APPROVED . . . . . . . . . . . BOARD OF HEALTH .SD S of s'77aNE M i E-AE.KEi.L'EY CO. ' DATE. . . . . . . ENGINEERS—SURVEYORS AGENT OR INSPECTOR 346 LONG POND DRIV SOUTH YARMOUTH,MASS, OF THO S P LoT �. . . . . . f riL';�s:l E /p��j 7�,may " `• ' +' lla.2420 NALL�"�'`� PETITIONER