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HomeMy WebLinkAbout0299 OAKMONT ROAD - Health -LOT#4 OAKMONT RD., BARNSTAR A= i o 0 I O :SSESSORS MAP NO. 3eIr- / PARCEL NO.: zz No.__(� Fims.......7. .............. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH f?n _037QW ............ .T w^�..........OF.....8 /sT9i9,BGE A 1iration for D asal ,arks Tontitrurtiurt Prrmit Application is hereby made for a Permit to Construct (e/) or Repair ( ) an Individual Sewage Disposal System at: _©AsGivo..yT 2osY0 !......VAA ez o--•--•---•------ .......-------------------------......T'...¢..............------------•--•------.......--- Location:Address -or 1 4--....._____ ---!'I.GL-xi__..----Mozr..... O'STL F!!�6 pO'reerr. Address Installer Address Q Type of Building Size Lot__ f.Z--•-----Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) QOther fixtures -------------------------------------------•----------•-•---•••---•--•-..._..----•-------•-•••-......--•-----•••-••--•---•----••-•-.............--•- W Design Flow................ ............................gallons per person per day. Total daily flow................ 3C�...............__gallons. WSeptic Tank—Liquid capacity../000.gallons Length Diameter________•___..._ Depth_-r8".. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area................____sq. ft. Seepage Pit No__________ _________ Diameter------e�O Depth below inlet.....!y............ Total leaching area...'!7....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed b �?Nil?...G=.. � !___________________ Date.T •__�� i9�S W Y y----- Test Pit No. 1-__-- .'...minutes per inch Depth of Test Pit----e� Depth to ground water-----_- _-_-•-•--__. rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -------------------------------------------••---------•----•••••---...---•-----•--• ------•-------------------•-•-----•----------••--------------.----- O Description of Soil........ Z4'� 6c!`'a�4&,A-'--7 S`�3-57oi L. ��/'� M f -------- x CL ram•----S n -•----•-•••-•-•-•••---•-------•-••----------------•--••---•---••-•......•--•-- 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 iiTs.:' 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance hasb�ue y the boar f�11.1 '41,tlhi�.Signe '----•-......---•••••••----• ............. Date Application Approved B •..................•---...._..•••--• ® - Date Application Disapproved for the following easons:---•-•••••----••••-•••--••-----••••...------••--••-•••-•••--•••••--•--••------••-•-•-•--------•-••---....•--•-- .-•-----•--•-------------------------------I--••-•---------•------------------------•----•--------•-----------....------•-•----•-•••-•_..._ Date PermitNo......................................................... Issued....................................................... Date. ` LZ Fx$........................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .--------70 .......0F..... 6�J�nlSTi9 G�._.....-•................................ ; Appliration for UWposal Works Ton.itrnrtion "erntit Application is hereby made for a Permit to Construct (v') or Repair ( ) an Individual Sewage Disposal System at: Gf-ilG�9Q ZDA-0 cc-" �T 4� ................-................................................................................ -•••--•---•...•--------••••------•-----•-•----.._...--•••••••-••-••-•.._...._......._•-•-•._...... Locaton Address ©S or Lot No. _ r My���.n rz '`�•-----. ----- ...................................................... ......................---•••••• - O ner Address �G�iSTi�fC..77v ^!---------------=----- .............. Installer Address ; d Type of Building ;� 3 Size Lot...G�_ `..___..___Sq. feet Dwelling—No. of Bedrooms_-----`-_-_--•-__•___--•_•-_•______________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a - ------•-------------•---......-•-------------------------------•--••-•--....•---3 Design Flow................ __ _____________-.gallons per.person per day. Total daily flow............_..__._-••--- .•gallons. Other fixtures _________________ _____ W g - g P P P Y Y • '��................. R; Septic Tank—Liquid capacity..AqSe gallons Length..$.'�.`.__._ Width.l'!�,"'.._ Diameter________________ Depth..-s'-d-:­ Disposal Trench—No..................... Width.............._..... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........./-----_---- Diameter___...Vic?_'_..... Depth below ........... Total leaching area....4�A: ....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) I." Percolation Test Results Performed by..L l��! zA>._.�`-._ E ��/................... Date_.��.__ X_-•-- -�S. Test Pit No. I-----�_.y___minutes per inch Depth of Test Pit....!�K...... Depth to ground water------.............. 44 Test Pit No. 2................minutes per inch Depth of Test Pit_................. Depth to ground water........................ P4 ••-•--•----•---•----••-••..._._.._..-••...•••-•.........................•..........•••••••-•----._...•-•---- D Description of Soil.------.. ---•--•-•--•--•--•......._....----•-•-•----_--•- 5?. Z , /�.. - -41 Wou�CvA� s`�'S_-5o{C. -�- . M[-v�FiN - ----------------------------- x C............ ----s •svp 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 T1, 1.E 1 of the State Sanitary Code— The undersigned 'further agrees not to place the system in operation until a Certificate of Compliance has b.en issued bythe board-of h .'Ith. ... Sign ........................ _ ' ................................ Date Application Approved By---------- . -• -•-•-•---� �-..................................... --------r .-_.1 �- Date Application Disapproved for the following reasons______________________________________________________________________________________________a__............ _ --•..............•--•-•---...----------•-•-------------------•-•----.......-------------......---....__..._..--•--....----------------------------------------------------------------------------------- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............. .........OF......... Ti9'ale C'-................................ (Ilertifiratr of Tomplianrr ; ±. THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (✓j or.Repaired ( ) -- by.................... ----------------------•••-• •-•••.............._...;..._....._..-----------••••-•------•••-••------ ------------ J I tarter , at.......L C!`�------• Q --- • .........I A�.. ' - --&I; •------ -----•------------•---- has been installed in accordance with the provisions of Ti T IE j of Th State Sanitary Code as described in the application for Disposal Works Construction Permit _.......__..`_ dated_.-----h)_._-1_� ........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................•-------------------•---•-•••••--••----•••••-•_. Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -- 1 b -emu,-A/ OF......... , «,��.� G ........................... O. _. _.... .. FEE........................ Difivooa1 orko ion, rtion rrmff Permission is hereby granted.............. -- •--............--�----••--•-•----- ..._.--------'•---:._......--------........................ to Constr ct (+�) o Repair ( ) an Individ� ge Dispos System A.4. ........................................... Street o U as shown on the application for Disposal Works Construction Per it Nook �' f �__ Dated-----/V— ............ lq .............. ,'2 1 � Board of Health DATE--- . ............................................................... ( A FORM 1255 HOBBS & WARREN, INC., PUBLISHERS TOP OF FOUNDATION CONCRETE COVER CONCRETE COVERS � 4' CAST IRON ` OR SCHEDULE 402"MAX. 12"MAX. —� P.V.C. PIPE 4" SCHEDULE 40 PVC-(ONLY) t • � PITCH 1/4"PER. PIPE- MIN. LEACH PITCH 1/4 PER.FT. PIT PRECAST o' NVERT e J LEACHING ` ° EL.. s7.•B�.. INVERT INVERT o . Q., PIT OR SEPTIC TANK 5 43 DIST. S "e INVERT EL....7<. . .. BOX >s EQUIV. /000.•.. GAL. INVERT ' � '•' INVERT ww o- ::�: 3/4"TOIV2' EL 57.,-3Z • EL.54:9� e' w �: .,. WASHED • o � � �� w '; STONE 5-i 121 lo I DIA.::!id PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE R- SOIL LOG WITNESSED BY : DATE :-�- !� �583 TIME.��%30 /ate '? s /yc/C��•./ BOARD OF HEALTH TEST HOLE I TEST HOLE 2 GsDtc// z1> Gs. ZL��/ ELEV.. ENGINEER �.7.7��. . . . ELEV. .... . . . . . . DESIGN DATA NUMBER OF BEDROOMS 3 TOTAL ESTIMATED FLOW . . 33v GALLONS/DAY BOTTOM LEACHING AREA . 7a: 50 - . SQ.FT. /PIT/6:P.D SIDE LEACHING AREA . . �Ba- �. . . SQ.FT/ PIT/47/C.PD, GARBAGE DISPOSAL (50% AREA INCREASE) TOTAL LEACHING AREA .Z� 7. . . . SQ.FT 4d /Co PERCOLATION RATE 4-.5S MIN/INCH LEACHING AREA PER PERCOLATION RATE . J`3q . SQ.FT/C,PD. Yq. .WATER ENCOUNTERED NUMBER OF LEACHING PITS . �^�� . �!T t�✓iTJ� APPROVED . .. . . . . . . . . . . BOARD OF HEALTH DATE. . . . . . . . . . . . . . . AGENT OR INSPECTOR EDWAR�/c;. r -� w z�cr . u� .01 0. 26100 0 iTi s $TOlk v STER�`c 17 s / i�'� �fit. L.�.4�0�, SINTF.R1p�� PETITIONER TOWN OF BARNS TABLE A LOCATION Lo 7- G 00/r ,� o v T /�� SEWAGE # ;Tb/ VILLAGE CvAl /7�9 ASSESSOR'S MAP & LOT-3 3�/ 2 INST ALLER'S NAME & PHONE NO.1QGL c/ 7 S 3 SEPTIC TANK CAPACITY /O O o 6s ` LEACHING FACILITY:(type) 4-.06 ,r r (size) laoO / NO. OF BEDROOMS 3 PRIVATE WELL OR B�WA _ BUILDER OR OWNER O DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED.- VARIANCE GRANTED: Yes No �J� /'� ^h\ V �.p�A6 C � �� ;�3 S3 Sz f + S0/ T 1 o�C Z rSM.vsf� ., 0 Vi' e ti lM I f _ 7 I Z3 Pilo -- I 1 I �5 - tip ' N Q�Sv o f � \10 23' i G 8Gi s�, fir. f 1 1 Z Z8 3z LOCATION SCALE . .�.�-�6�.... DATE PLAN REFERENCE . BN7•vG..�T'r -Stib w�• ov P�B1c: 3s� vasPC �3. . . . . . .. ... .. .. . . . . . . . . . .. .. . g EOWS G . s1 . . . . . . . . . . . . . . .. . . .. . . . . . . . .. . . . . . . . . E ,I' , _LEY �! . .. . .. . . . . . . .. ... . . . . . . . . . . . . . . . . . . .. . iVc. 26100 . �n f 1 CERTIFY THAT THE !Sn'!�: s�lpcG1$1ER`�a�r ASHOWN ON THIS S SHOWN HEREONAN IS LOCATED ON THE GROUND DATE ��� 7>�9v�o ��� — ��T►Tio�vt� !' REGISTERED LAND SURVEY R