HomeMy WebLinkAbout0110 MARBLE ROAD - Health arb
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LOCATION SEWAGE PERMIT NO.
VILLAGE
61 E
INISTA LLER 3 MA ME & ADDRESS i
s U R D E R OR OWNER
JULG 54,11c ' O 6ZIC GcA, ti 7-
DATE PERMIT ISSUED . V_30wy
DAT E COMPLIANCE ISSUED 6
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No.aw.--oa. Fims....0.............
t r THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
............:7._w^...........OF....... ....................................
Appliratinn for Dispaii al Workii Tami rnrtinn Frrmit
Application is hereby made for a Permit to Construct (&,,r or Repair ( ) an Individual Sewage Disposal
System at:
�9
....il .....��: s-------- ----------•---....----------------....�-0..7"..3G...........--..........................
/? Location-Address or Lot No.
F............... .... SS...................
Owner Address /�
.......................................... eC�,/crs /J ..
Installer AddrAs
Type of Building Size Lot.4410/0........Sq. feet .f
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building No. of persons---------------------------- Showers — Cafeteria
a' Other fixtures ............................
W Design Flow..............��..-�.......____.........gallons per person per day. Total daily flow..............�30...................gallons.
04 W Septic Tank—Liquid capacity./Ag!..gallons Length.. _����._ Width_¢'G"'._ Diameter_............. Depth..,��8�.`.
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area_____-__----•---_-sq. ft.
Seepage Pit No---------- Diameter.....Zd _-___- Depth below inlet..... ..........Total leaching area.� .......sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
'-' Percolation Test Results Performed by--- i � l� y..T��_:_._ Date_.��N -_-Z _..............
--
Test Pit No. 1...G-S..minutes per inch Depth of Test Pit----t; ....... Depth to ground water..............
fi Test Pit No. 2................minutes per inch Depth of Test Pit...Z43....... Depth to ground water........................
f� ---------•-----•-------------'----••'------•-----•---•-•---'---...............---••'•--..._..................................................................
0 Description of Soil..... 36 f C -i " [3 Soi6 �-'�...................'
x ...............................................................
U -"'--•-•-•-•--'•--•--""••---•--'-•.....................'-•-'•"'•'•--•'--'-'•'-'-.........-'••-•-"•"--'•"•'--'---•'--•----•-•-•--.........--''--
w ----'--•----------------------------------------•------------•••------•--•'••--••-•-•-•"-•---•----'------------------------••-•------••----•••"--'...-----•••---••'--'-------•---------•-'--------•--.
U Nature of Repairs or Alterations—Answer when applicable................................................................................._......._..._..
O
...................................'..................................................................................._................._...........__.._.__..._........_............................_.
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Code—The un rsigned further agrees not to place the system in
operation until a Certificate of Compli ce ha een ed by th oar health.
Sid.•-- '-••-- .. . ......'-•• -•'•-•-----•......-"...••••-•.•...
Application Approved By..
--------------
Date
Application Disapproved or he following reasons: . --- ----- - ----------
............................---------•-----•-•-----•--•-----'-•---.......---------•--'---...-•----......••-•-••••••-••...•-------••------•----•••••--•--•'---"•-----'...-----•----••-'---'--•...--....
Date
PermitNo.............•-----.._.._...__....------•-'------------. Issued---------•--------'--•--•-'---'•--'-------------------.
Date
ti
No FEE .................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...........�rWA?�.............OF......497Z/V,57i ------*.................................
Appliration for Uhiposal Worko Tomitrurtion "permit
Application is hereby made for a Permit to Construct 0.1-1 or Repair an Individual Sewage Disposal
System at:
............t5
..................... ........ ..................................................................................................
Location-Address Lot No. ss
. ..............
Z..... ... ........ 111A ................
Owner Address
........................................... ............. ......................
Installer Address 44
Type of Building Size Lot...... .........Sq. feet
U
Dwelling—No. of Bedrooms......_....3...........................Expansion Attic Garbage Grinder
04 Other—Type of Building ............................ No. of persons....._..................... Showers Cafeteria
Otherfixtures .....................................................................................................................................................
Design Flow.............—6-46 .....................gallons per person per day. Total daily flow..............3---To.....................gallons.
9 Septic Tank—Liquid capacity/9 _._gallons Length.A_Z....... Width*4_/6/ ... Diameter................ Depth.4 � .....
Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. f t.
Seepage Pit No--------/---------- Diameter....49_......... Depth below inlet.... ............ Total leaching area.?�_._�........sq. ft.
Z Other Distribution box ( ) Dosing tank ( ) --
Percolation Test Results Performed by--- a m .. ........ ........................ Date. !'� ...ob? lie 3
......71-----------------
Test Pit No. 1.. ...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........................
----------------------------- ...... ....*----------------;;�';;---------------------------------------*------------*-----------
0 Description of Soil..... ....................... .....................................................r...............................................
.........................................................................................................................................................................................................
U
.......................................................................................................................................................................................................
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 TITLE 5 of the State Sanitary Code—The untrsigned further agrees not to place the system in
by th, _a. 0
operation until a Certificate of Comph C42 hha',�We7rV7uieldl by?,nDoa5if health.
Sig ---- - ---- .. . .......... ................................
3y_ —-- ---- ------------------------ .................... ..............
Application Approved By.... ........................................... ....................................
Date
Application Disapproved or he following reasons:-....-. ....................................................................................................
.........................................................................................................................................................................................................
Date
PermitNo........................................................ Issued-........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
............... BO A RD OF......H.....E...A....LT H
.........OF.... �. evFP6—..C........................................
Tinfifirate of Toutpliatta
TH,, C—ERTIFY, That the Individual SeW a ag Disposal System constructed (4-) or Repaired
ag alley
--- -- ---------
by ........ ............ ................................................................
------- ...I ----------------------------------Zl�
0
at , -----------111-ilt --- - ----------------------------------------------------------------------------------------------------
has been installed in accordance with the provisions of TTTLE 5 of T4fe"State Sanitary Code as described in the
application for Disposal Works Construction Permit
_V11-4-123................. dated__..___.._.._.._..._._______.___.__._.._____....
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE..............................................I ........... Inspector....................... ..............................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
No. .............70 A-/-Al............OF........ - .............................. 'r'V
....................... FEE..
Xonotrurfi u "amit
Permission is hereby granted.............. ........ .. ............ ............ . . ............................................................................
...... -----
I
to Construct Re air -/D an Indi-vi e g, ispo stem
atNo.......... .............................. ................ .................. ..............................................................
Street
as shown on the a ica 12 or Permi 0 ................... Dated_._______..._....____.__________..........
'ppli ti f Disposal Works Construction Per
................ ......................i.............................................................
DATE... .......................................... Board of Health
FORM 125 ',k. M. SULKIN, INC., BOSTON
SNc�-T � of 2 Sf-!EZTs
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CERTIFIED PLOT PLAN
LOCATION
SCALE . �.��=so'. . . . DATE
PLAN REFERENCE . . ,$ 7�/G, . LoT 36 q
EDWARg
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. . . . . . . . . . .
O
'TISTEA�a
44nsu84,0 1 CERTIFY THAT THE EXisrrwG iwG....
SHOWN ON THIS PLAN IS LOCATED ON THE GROUND
AS SHOWN HEREON AND THAT IT CONFORMS TO THE
SETBACK REQUIREMENTS OF THE TOWN OF
8.44. . . . . . . WHEN CONSTRUCTED.
DATE
,�oG�7� �oN�n�7-- �CT/T/dNEr� �f�i-r�•�G S' ���
REGISTERED LAND SURVE OR J.
sH�T z of z s�/CL�s
zo
``TOP OF FOUNDATION
e CONCRETE COVER
CONCRETE COVERS
I9.86 a 4"CAST .IRON 121'MAX. 12"MAX.
P.V.C. PIPE ""'""'n"•�A
OR SCHEDULE 40 4"SCHEDULE 40 P.V.C.(ONLY)PITCH I/4"PER.FT PIPE - MIN.PITCH 1/4"PER.FT LEACH
PIT PRECAST
o' INVE T Q < LEACHING
° EL••..3 S• INVERT INVERT 'p W a PIT OR
all SEPTIC TANK Z �! DI ST.
° INVERT EL...7. r. .7. BOX EL.X?c P. " ; >_ EQUIV.
/oop. .. GAL. INVERT �.
INVERT G w w o'
EL.707 �. :i; 3/4"TO I I/2
.`� EL7l.•.74. �� \: WASHED
STONE
°:,• . , /o' DIA. er�c�u�sx�
PROR LE OF GROUND WATER TABLE
SEWAGE DISPOSAL SYSTEM
NO SCALE
SOIL LOG WITNESSED BY *
DATE .9�!`W '7
�9,83 TIME. . . . . . . :. . . co&/. ,9•S•• BOARD OF HEALTH
TEST HOLE I TEST HOLE 2 ,2.T b'h/&WraA-j TA/C- ENGINEER
ELEV. . .73./o . . . ELEV. .7'¢7�. . . . . . .
77
Co?�
36r DESIGN DATA
t2.7v.�o -G,7/7, NUMBER OF BEDROOMS 3 .
TOTAL ESTIMATED FLOW . . 33v GALLONS/DAY
s/LTY 5/47Y BOTTOM LEACHING AREA 78�� SQ.FT. /PIT.
SAD s-9�I� /813,✓�o
SIDE LEACHING AREA . . . SQ.FT./ PIT
GARBAGE DISPOSAL .N �`r.(50 % AREA INCREASE)
TOTAL LEACHING AREA Z6,7 0o SQ.FT
EZ,Lo,/o /• dy 42 C/7o PERCOLATION RATE . 771~. `-. vG, MIN/INCH
LEACHING AREA PER .PERCOLATION RATE . LBr 6 SQ.FTIC.P.D,
.IVA .WATER ENCOUNTERED Per WiTi�1 NUMBER OF LEACHING PITS . . ?�Vo
APPROVED . . . . . . . : . . . BOARD OF HEALTH � T OF .STnN` oN ,9GG. .S�Jj
DATE . . . . . . . .
AGENT OR INSPECTOR
OF ���SN OF fi%s,
G
Z>. 3G_49 i ELLEY
No.26100�O i o
M F
/V.S i9�CL_ ' /i */STEP 0 1STE
PETITIONER : �NosuevEr� SAnrtAVLN
r... ....
THE COMMONWEALTH OF MASSACHUSETTS
bZp� BOARD HEALTH
db /
Appliraatioaa for Biiipn.ittl Workii Tonfitrurtion Punfit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System t
�cat' Address r Lot No.
Ve
•--•--•• •-- .... ---------------------- ..49— � �
/� g �Ow(/Q�� A ress
a ....... -- -.i'."--�'----- ---i�/+�i-/-d•-�- -- . . .................... ................................................w.•---................................ -- --
� Installer '�.t, Address
d Type g 7_v_.Sq. feet
e of till
Size Lot.- �`l'_.
U Dwelling -Expansion Attic Garbage Grinder ( )( )�No. of Bedrooms------------` --------------------------- —
aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) Cafeteria ( )
a' Other fixtures
------------ -----------------
W Design Flow................ .._...._..._.__._gallons per person per day. Total daily flow........... ____ __.._ .-..-gallons.
WSeptic Tatik—Liquid capacity------------gallons Length---------------- Width-__----�_. amet r__-------_.__-_ Depth..-.__-.-
Disposal Trench—No. . Wid ngt al Ching area sq. ft.
Seepage Pit No.-____`___-____-__ Diameter. _. .._ _..._._. be o let____________ f leaching area------------------sq. ft.
z Other Distribution box ( ) Dosing tan ) /
Percolation Test Results Performed by......:'" "IC Date J?lz
{ _
Test Pit No. I....../-------minutes per inch Depth of Test it____________________ Depth to ground water..-__-_---_-_--.--.-----
fs, Test Pit No. 2----------------minutes per inch Depth of Test Pit____________________ Depth to ground water._._.-.--__--__.-_-_-.---
a •---.......•. ------ - ------ ---- ••--e
O Description of Soil------ ----------• 'G�, ---
( 1 s--------------
Cxj f
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 Article XI 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 board of health.
i- . y yate
Application Approved BY tomg
Date
Application Disapproved for the following reasons_____________________ ________.._:_
---•--....---•--•-•..................................•--••--•------------••---- ----------------------------- 1
.........................Da e
No....Z�:_e ......"::�"....
...-=------• Fss.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEA�-L�-T/H
.......... OF........ �.>...G..�-�2yv!. ✓°rar'g -------------------
Applirtt#iun -for Ditipmal Workii Cnonotrur#ion Vrrmi#
Application is hereby made for a Permit to Construct (V) or Repair ( ) an Individual Sewage Disposal
System,at: 1
.....-f)_...:r;J ...� i^. �....... _........_._
/t _
Locatisn Address j or Lot No.
--___...� ......................... .....1--......_. •' Ci_ i....."Y .l'.L .(.Stei'^...✓_..____._. 2:...�
Ow Aess
W
Installer Address
Q Type lofuilding Size Lot_____7,__3__7.l.Sq. feet
U Dwelling�No. of Bedrooms.._.___..._ .._ Expansion Attic ( ) Garbage Grinder ( )
---•- -
aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( )
a' Other fixtures _.---.-.._
Q ----.- - - -- - -----
W Design Flow.................. ..... ................gallons per person per day. Total daily flow.....___._... gallons.
J
WSeptic Tank—Liquid capacity_-------------- Length---------------- Width................ Diamet ................ Depth.---_.---_---
x Disposal Trench No. ..............:..... Width...... ___ .._.. 1 ngt otal 1 chin;area..._......._..___-.sq. ft.
Seepage Pit No------/---____--___ Diameter _ et___ o leacliil;ig area.-._._ ----------sq. ft.
z Other Distribution box ( ;;) Dosing tan (t��,)�� �
Y �: 'l
Percolation Test Results Performed b..__:_... .__ ,,�� _'e:__dull___t,... ___ Date_---�----�/_ -�_.
a Test Pit No. 1..._../_-___--minutes per inch Depth of "Pest Pit.................... Depth to ground water...----.-.---.-.--.-----
t14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-..-..-----------_--.---
g t: 3G
- ---------------------------- -
� 1 t 0 Description of Soil , '. 1 - G
i..= ...... --------- — ------ ----------
VW
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 AAicle`XI 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 board of health.
E
Signe,/d� -- /j .... ..s_.••••---•...--•-..._-----••---•-------------- .`. ....... ...._•-•-•._....--
t f ! Y � !' ` / 6 Date
Application Approved BY , =' ;` �.. !a�I s if ........................ Datder
Application Disapproved for the following reasons:......-•----.......V-------------------------------------------------------------------------------.........
-•---•.............•--------•---•----...--•------•-----------------------•----------•--•-•.....-----------------------------------•--•----------•-•. -••---•--•- ------•---•-----------------•--------
Date
Permit No......................................................... ;Y Issued---��" -•-`-a-7-
e�. Da
e
THE CO ONWEALTH OF7[MASSACHUSETTS
F
;BOARD OF HEALTH
err#ifir #r off�laut ltaurr
TIf S IS TO CERTIF hat t n idhal Sewage Disposal System constructed ( -or-Repaired ( )
- ---------�_5
-----=--------------------------------------------------------------
�j y'J /� InstallerC��
has been installed in accordance with the provisions of Article XI of The State Sanitary Code as des .ribed in the
application for Disposal Works Construction Permit No--------------------- .. ............ dated F . ; ...........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTI N SATISFACTORY.
DATE--- iZ --- -------------•-----------•---. Inspector---- -`7----
THE COMMONWEALTH OF MASSACHUSETTS
��. BOARD OF7 HEALTH
,,ff
t... �I` '�. .. ......OF..... .--6"wr' dJ .- ... .............
FEE...
Bitv>al l IV n r dear Prrmi#
Permission is hereby granted- 't� -- . ... --••.............................................•-••-----
to.Construct or Repair O an I Ividual ewage Disposal System
--•-• - --• r ....................................
• 'Street . ,. 4 f_
as shown on the application for Disposal Works Construction Per"it No. e'..____.'_.�_--Dated_ r ::,�t :n_________
��`"�/ .........................
} Board o Health „fe
.`DATE-l_ ------ -- -
FORM 1255 HOBBS & WAR R N. .tNC.. PUBLISHERS
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IdROF/LE OF CROUNp WATER 77.4B&
SEWAGE DISP'OSAL SY 7'EM
N O S CAL
SOIL TEST- x
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