HomeMy WebLinkAbout0024 MARBLE ROAD - Health 24 Marble<R`odd
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ASSESSOR'S MAP_'NO. ZI w PARCEL SO
LOCATION-`"q SEWAGE PERMIT NO.
1s�TZ�oP� by g
VILLAGE
UN&A1Le f�sR
IN�STA LLER' NAME i ADDRESS t
I,r
- B U I L D E R OR OWNER
E �
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED 1 � �
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BCK
ASSESSORS MAP NO:
PARCEL NO:
No...YD.......... Fes$.. ....-�.............
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
--------- �WAI..............OF........BA?ZNS �3GGs_.....---------•--........_...--------
Applirati.an for Uiip.aiial Works Tonstrnrtiun Prrmit
Application is hereby made for a Permit to Construct (c j or Repair ( ) an Individual Sewage Disposal
System at:
... ? r.:lzo n �tiYr�.vsT/�BGC-•--------------- --------------••------....---......47 `.`Z�A
Location-Address or Lot No.
.......N..iGG�A -••••-•�•--•5'w..F�' r x i�g ,B9rr..vs . �
- ........................................................
er Address
v'.. ..........•....................
Installer Address
Type of Building 3 Size Lot..'¢3.-' �._._•..Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Q' Other fixtures ..................................
W Design Flow.............. ...................gallons per person per day. Total daily flow__._..........33b
.................gallons.
9 Septic Tank—Liquid*capacity.14 off?-gallons Length-_��'A.`.._.. Width.'¢.'6 o.. Diameter................ Depth. .'..
W Disposal Trench--No._____•______________ Width.................... Total Length.................... Total leaching area--------------------sq. ft.
Seepage Pit No---------/--------- Diameter........�A___.._. Depth below inlet......G..........
Total leaching area._:�39.....sq. ft.
Other Distribution box ( ) Dosing tank ( )
`" Percolation Test Results Performed by.._r __....WTI!�G.......................... Date__. :..�� �gBZ
Test Pit No. 1...G._Z----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_.__..D_��:Z4y k!ooD4&4--Z F �riB-S®i L Z4`- � C-04=Sd .5
•-- . . --•----------------------------------------•----•----------------------------•--•-..........._..
IMiTH -=S%OA� 8¢"-/62`-----7� 5�� N/ -5'AV-0 /d2_- -/74-" I-I&V__"..-5Am
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
the provisions of TIT:_.E 'of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has be he and
S �ned-•-...... ....-•---••--•••--• •-- ... ... ....... ......................... •• -•---•-•--•-•................•--
Dat
ApplicationApproved BY ---•--•----•-••------•••-_....�..........--•-••--•-- •---•...................•---•--••- Date
Application Disapproved for the following reasons-..............-------------•--------•--------- ---------------.---------------------------------.------------
----------•---------••-------•----•---------•--------------------•-------------•-......---•-•----------..._...-•---------....._._......----------------------------.....................................
Date
Permit No.. ...... -
Date
r'w..
No._..=.v. .....
7 .........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
To UiAi e1Q7ZA/5 --*7 C 4
....... --- --- ---- -------------OF......................................----------------------..._...........--••-----------
Appltrattnn for Dhgpniittl Works Tonstrurttnn ranfit
Application is hereby made for a Permit to Construct (Vj or Repair ( ) an Individual Sewage Disposal
System at:
1`14143cc- A'In, Biar�vsr4a4-- 47- �z�A
................-........_...................................................................... --•-•---------------.......--•-•-..............-----•-•--•--•----...........-•••-•--•-............
Location-Address or Lot No.
fit//LL/GN9 / SW.FT ,Box /08 ,$RIZnisTJ'f3GC
--....-•-------------------•-•-••-•--•-•------------•------•--•---......--•--------•--........... .......----•--------•••---•--•-•-••---•----•-•-------•----•--•.....---..................-•---••---
Ow er
--•••...--- Address
W �ic�Cl c7} fib C,A;A l7 Z1//GLG�
a •---•-••--•..................
Installer t/ Address d v Type of Building 3 Size Lot.....�3..................Sq. feet
U Dwelling—No. of Bedrooms................................ .....Expansion Attic ( ) Garbage Grinder ( )
Other—Type T e of Building .............. No. of ersons......................_..__. Showers — Cafeteria
a YP g -------------- P ( ) ( )
QI Other fixtur s •••-=--••••-•--••............•••-- --- •-- -•-.....- --
W Design Flow..............................•..........._.gallons per person per day. Total daily 35c>
............................. gallons.
Rai Septic Tank—Liquid capacity.�d°__gallons Length..s 6....... Width.'¢..a.. Diameter---------------- Depth. --6
W Disposal Trench—No. .................... Width`.................. Total Length_..........j__.... Total leaching area....................sq. ft.
x
Seepage Pit No.___...._�--------- Diameter.................... Depth below in et.................... Total leaching area........._.:._._._sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
'~ Percolation Test Results Performed by __....tvp.,T!�G............:............. Date.._ ��8z
a •..... .
a Test Pit No. I...G...7-.___minutes per inch Depth of Test Pit.._._��`�. ... Depth to ground water_......_'............
44 Test Pit No. 2....L....
...minutes per inch Depth of Test Pit------ --- Depth to ground water................__..
t4 ---------..................................----------------------------•-......... �...... ,......................................................
0 o Z-0 ' w00%x04-,7 �`Sv8-Sol c, �4 - Cv 1SL' SASi�
Description of Soil ----- •-- •••• ....----
',>'r' Iw/TM S70^16-4 'y /6 2'' 7,�'E�uSC �Nc .�A�D /G�"- /�¢" f9�'D_ .SAtivvp
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 T:. =.-.i.p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has b e ar
_ S-fined_....--- -•---- ---------- ---- ---------•- ---------------.......... -- •---- --------.........--------
A Application Approved B CU(J't „�-- //Z-�/�G�
PP PP y----•--------------•----------.......-----------...........-•_... ................._---•-•. // D ----------------
Date
Application Disapproved for the following reasons---------------------------------------------------------------•-------------•-----.............................
..................................
...-----•--------•---------•----........
------...........................................................
•-•-•-••••----••--••-----------•--•••------••••---•--•••------
_ Date
PermitNo........... ..................... . ....._ Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
77) ��7Z�/.sTi4ls LC
..........................................OF ..............................
Trrfifgratr of Tnntpltan e
THiS7S TO gERTIFY, t the Indi^v dual Sewage Disposal System constructed (L-r or Repaired ( )
l l C� Q �e..r L�`
Installer
. ( �--------
,-1 7=�------ ----- -------------------------------------------------------
has been installed in accordance with the provisions of TT� - j of State Sanitary Cody as glescribe�in the
application for Disposal Works Construction Permit No.__..__`�C�.__.�....__. dated_.-..__...._—_.7../_-?-_'..............
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE
SYSTEM WILL F NCTI N SATISFACTORY.
DATE.............1-6 L3 / o ... Inspector.........1.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..............ToI.✓............OF.........8!47avST 13�� �--► --
.......................... J
No.........................� FEE........................
t pnlia1 nr1 s Tnntrnr�inn rrntit
char. {� �
Permission�Is hereby granted ....................... . == .....................................................
to Construct (am ) or Repair ( - an I dividual Sewage Disposal.Sy tem
Street 1 � '
as shown on the application for Disposal Works Construction Permit No C�5 __...2�c-7_�V.... Dated....��
f
GL • -- -...--
O 2 Board of Health
DATE. ( `
FORM 1255- HOBBS & WARREN, INC.. PUBLISHERS y
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LOCATION �Ir!vsT/fiL
SCALE . .!.��-�'4?�.... DATE .s ?T z?v58G
PLAN REFERENCE G' ?�!G �?'aZ6'9
• ���AL�n OF �}�by . . /�.. .. . . . . . . . .. ... . . .. . . . . . . . . . .. .. .
� ll RD G�
/// KELLEY
� No. 26100
���s 9E�,IS?ERGO rs` I CERTIFY THAT THE
sip�A SHOWN ON THIS PLAN IS LOCATED ON THE GROUND
L LL AS SHOWN HEREON,
DATE S�nT. 2z 1986
REGISTERED LAND SURVEYOR
TOP OF FOUNDATION
A s CONCRETE COVER
CONCRETE COVERS
4"CAST IRON 12"MAX.
OR SCHEDULE 40 4"SCHEDULE 40 PVC-(ONLY) 12"MAX. •
P•V.C. PIPE
° PITCH 1/4"PER.FT. PIPE- MIN. LEACH
PITCH 1/4"PER.FT PIT PRECAST
o'c �INVERS Q LEACHING
EL.. 7. .?g.. INVERT INVERT e•: PIT OR
SEPTIC TANK DIST. 7¢3L ; w : EQUIV.
a INVERT EL...7 -7.� o . . BOX
a; EL. ?` .87.. (aov.. .. GAL. INVERT �i E-t- a.
�'a 'o� 3/4��TO I i/2'
� EL..`f..p IN�VE 34 �o d: :�.
o EL...:..:.. �� �. �,. WASHED
w STONE
350
Z/ • —t
• 6 DIA. �.. n°. E
o• . e, �-- /z ' DIA. co�vre�eea
•o•
PROFI LE OF GROUND WATER TABLE
SEWAGE DISPOSAL SYSTEM
NO SCALE
SOIL LOG WITNESSED BY :
DATE FHB.. /7 i99Z TIME. /!-�. !� ��^� / /Zp j2'.s• BOARD OF HEALTH
,, . . . . . . y. .
TEST HOLE I TEST HOLE 2 / i AcC Wi-/17-/1/G ENGINEER
. . . . . . . . . . .
ELEV. . .80. /o. . . ELEV. .7`c.7?. . . . . . . . . .
Woo�DLo2,1 wo 4a/dr7
2,4" S�g.soµ, s B-So DESIGN DATA
78.
tZ. /0 'Gr
Co qxs� --Z,7/,9o
NUMBER 3
F 0 BEDROOMS . . . . . . . . . . . . . .
5,qa� pent•
.57v- CD C TOTAL ESTIMATED FLOW 330 • GALLONS/DAY
eZ. 73, io BOTTOM LEACHING AREA !�3.� . . . SQ.FT. /PITIC,P D•
'rl,j ��� �z.6¢,90 SIDE LEACHING AREA . . .Zz�. .? . . . SQ.FT./ PIT/5ZSG,P,p.
Deals6 GARBAGE DISPOSAL . !`!6^��' .(50% AREA INCREASE)
�Gz ez,4.4( o TOTAL LEACHING AREA �39.3 . SQ.FT
so PERCOLATION RATES / !.r�!/Q. MIN/INCH
i�d' �z.cs t d �80" �z.•s 90
LEACHING AREA PER PERCOLATION RATE .G78:!SQ.FT.1C.P,D
.No.WATER ENCOUNTERED o.v�r /
NUMBER OF LEACHING PITS . . . . . .1- 7- v1/77�. . . . . . .
APPROVED . . . . . . . . . . . . . BOARD OF HEALTH? ,Fri•°�•`S?�^!�.GN �2G S/I��S
DATE. . . . . . . . . .
AGENT OR INSPECTOR
Of iygs
ON
EGVJARJJ� %J u.
�T # .� y
'4(ZLLEY N
fCl$TER�� sgnrtks\a�'
. / fQL LAt+1U
PETITIONER w,GL� A•'