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HomeMy WebLinkAbout0399 OLD JAIL LANE - Health ASSESSOR'S MAP NO. — PARCELF) �� /®-35;' LOCATION tEWAGIPERMIT NO. PILLAGE c. 4 ,7 • II .INSTAL.LER'S, NAME i ADDRES, 7A- e U I L D E R OR OWNER DATE PERMIT ISSUED DAT -E C 0 M P L I A N C E ISSUEDaI . i4w" f (�� � �'�../ ':�, � �GA Y _�:Y4A`a`.i . `���.`t - e-:::r' t �� 7�4 �' ' .a;<, �"*y. 2 �� � �� _ �� 1 � � ' � / /^ , 1140 64 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .P..VVIV..........O F ..../3.7.9 /./ Appliration for Disposal. Works Tonstrnrtion f rrmit Application is hereby made for a Permit to Construct (j/jor Repair ( ) an Individual Sewage Disposal System at 1:.gi.�.O. C ..ci l..b9 Y Q:.�.. c��-r►s+ :�.7.-_•2=D .....o��( �/ </. .�......... Location-Address or Lot No Y ... W Owner r-----c y-� Address a ._. .......... ... .. ...•--•-.. -.... ..................._..---......................................................_.. ............ Installer Address Type of Building Size Lot3_......... Sq. feet Dwelling—No. of Bedrooms.................. ........................Expansion Attic ( ) Garbage Grinder ( ) aa Other—T e of Building yp g __�esSS_._�.__. No, of persons........._`�.-�...:........... Showers (�-- Cafeteria dOther fixtures ...............................•---.....--------................-----------........-----.......-- -----•-••••.... W Design Flow.... �...........oQ..gallons per pers`n45r day. Total daily flow............. .............................gallons. WSeptic Tank—Liquid ca.pacityr�....__gallons Length.......'.' Width..-=C/'?n Diameter................ Depth....4..- x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No.........1.......... Diameter......./.. .L Depth below inlet.....A.(........ Total leaching area...4.z..sq. ft. Z Other Distribution box (✓j Dosing ta�I e a Percolation Test Results Performed by.... ..............................,Y........ .. Date........................................ Test Pit No. 1......: _-Z.minutes per inch Depth of Test Pit........(..3:..... Depth to ground water....!. �......_�` f3, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ............. ....... -----.............._... .........................�........... ....... O Description of Soil............. � . .:..�----••--- ._�: �... ... ......... ..............•-----•--� -? 1... `^ Q" ....._... ✓ j, ..sr3............................... U -------------------- / ... .......:.. W ___ __ U Nature of Repairs �o,�r Alterations Answer when applicable .. .................. _.......... .................................... ..................I................. • . ....................................................................... .. Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of IT%i 5 of the ;State Sanitary Code— The undersigned further agrees not to place the system in operatio until a C rtifica. Compliance has been issued by the board of health. a ---. .. .......---• Signed_,} .-.,�....Z ��- 1 2-8 S APP ation 'Approved :X: =`ter"`6.. ....5�� �G - t" Date��...... •••• �-•-•-•.-• ....•• ... t - -.._ .. Date Application Disapproved for he following reasons:---•..........................................:..................................................••-•-.......... ................•----------------•--...............----•------........................----...............................---------.........---------......------......................................... Date PermitNo...................................•---•-•------.._•-•--• Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH JT4rV✓7�.........OF..... ............................................... j Appliratiott for Disposal, Works Tonstrurtiou Prrutit Application is hereby made for a Permit to Construct (y''or Repair ( ) an Individual Sewage Disposal System at: �.:_...1.1..1j.1 r.. l�A` /1 G %Cr . - -- 1 �. ? }•� rj_ y _ C Q Location-Address' ; or Lot No - - - -- _ ) Owner �-�--�--'-^--•- f � ..._ - Address.--•............. .............. Installer !!� Address ..1. Type of Building Size Lot..R.......................Sq. feet Dwelling—No. of Bedrooms......................... ....__....Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building .._� --_.... No. of persons.........:`_z. .............. Showers (�-) — Cafeteria-(--)-' 04 Other fixtures -- ---------------------------------------------------------------------------•------- -- W Design Flow...................:.:..................__..gallons per person pper day. Total daily flow....._....... .®...............gallons. WSeptic Tank—Liquid capacity_.°Q.gallons Length!`6'�._."..��t Width.;47.'.�%'� Diameter................ Depth....------------ Disposal 3 x Seepage Pit No........J.......... Diameter.......1._° .... Depth below inlet.....G'.......... Total leaching area..4Z.l...sq. ft. Trench—No. ......'...._ Width................... Total Length.................... Total leachingarea....................s ft. Z Other Distribution box (v') Dosing tank.( '~ Percolation Test Results Performed by....*...... _... �_.p__� ?!.............................I.. Date......_..___..:. ........................................ ,.a Test Pit No. 1.....__...--':..minutes per inch Depth of Test Pit........ Depth to ground water....L. ...-..."�_.. 4 Test Pit No. i.....0.........minutes per inch Depth of Test Pit.................... Depth to ground water......................... a ..---------•---------------------------------- ------ .............:�............. ............_.. ......:. Description of Soil..:... .. ....... ......... ...............................Q.... 1....�✓`.. ?. ......... ...... .............. ... UW •-•-••-•-•---------•--•--•-•••---•••-••...•••-••••-•••-•--------•-•-••••••. ..........--------•---............................................................................... 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 TITL.i: 5 of the State Sanitary Code— The undersigned further agrees not to place the system in ope}`{r`.atio until aCtifijcat Compliance has been issued by the board of health. �..1.,-1(_,Yl�( v ;1 — j Date APP ' ation Approv ed :...... ............ JtC.�." � _.... . ........... ... �1 ..•.. Date Application Disapproved for he following reasons----------------------------------•--------------•-------------------------------•-------••......-•--••.....••... . --------------------•-----------------•----------------------------....••••.....-•••••... Date PermitNo......................................................... Issued-.................---------------°......:..........: Date THE COMMONWEALTH OF MASSACHUSETTS ' BOARD OF HEALTH .110 �i (9rrtifiratr of Tompliattrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed I-)or Repaired by................... :._.._... .-•--••...................•••••. ( ( )-- `.'."�....._. � f,... Installer ...... .......................................................... L ....� - at....------ r..__ �..................`J �_.__.....: "' ? '"`7 ' ......................................... 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.,..............'_........_.4._....... da.te<i........... .................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUN S IS CTORY. --'' DATE...............................r ... .............:....... ...: -Inspector... ':.._......... - ................ i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �� y� .... :r"A✓.........OF......: r9? oY'_S.i• /' .. ....... No p s 11� �{ a f �QOG 1 .. ................ /� r � FEE ...................... io o orks Tonstrurtiot ermit Permission is hereby granted............. . .. ..... ! .......................................... to Construct (/---y or,Repair•( ) an IndiVldUa Mahe Disposal System r,v ------•-- ......------------------------------- ----------------------------------•----•-------------•--...... r Street •' as shown on the application for Disposal Works Construction Permit No.......... ......... Dated.......................................... 9 r of lfealth '� lfo 7'i'r . ` r DATE................ ..� ............................................ ,;:• -' \ SO I L LOG 44 3 4, WITNESSED B Y iss '� WOOD , L C) i r✓1 .�-.. At i ` Ar 4" /Ic S,q A/D tj © � $ �' \ 4 - 5 ►` ELEv TOP OF LA NHOLES AND COVER TO BE BUILT WITHIN �,: FOUNDATION OF FIN ISHED GRADE _ 11 / F.e) C N_.13'`4T_ _ ;%' FIN KA I s %k .0` `+ 1 � Jam_ + SHED 6RA E N 2 � SLOPE 4 C AST ' R O 4,; p y C S C PVC SC H 40 '•'-'•4�.. � ~' ':. P : T C H I FT4 O + 5 T -- , —T �4 2" L E V E'L, 0 kA I N 2 LAVE R $ 1 ti✓ ` _ p P 'TCH . 1/8 „ _ 1/2" PEAST NE pl �C rra/NKZ I f/ _�! IR, qFT / Q 7T \ � fCfJ �) Fr1INVEPT DIET. U !` ` t>� >'7•, aKOW \ y� f INvERrT e, INVERT GALLON t y. 47 BOX INVERT' e'a N ©•CL 3 4 - 1 1 2 DIA SEPTIC TANK �, ? 4 ..D Q I CO 1 tt • : + INVERT �'•.p uuD. : WASHED ST0r tia `-'l ,. , ! ii •\ v (`NVERT eoD w ` (]*' ALL AROUND M i N_ - GARBAGE s R N D E R • -. ..._...-...�,,..; { .... __4'�.. ' p__ _ a-,_C) V. "B'O T T O U �{ _ -- . .. E OF P T c / >a -0 p1A- /v 20� U ( N �.r. 6j +� . ` • j E L E PRC') r L E ifr GROUND WATER TABLE Z2_ L SAN IT' ARY DISPOSAL SYSTEM NOT TO SCALE DESIGN DATA ---- ' ��•�' _� BE o R o o M s 81° _ ' � • CONSTRUCTION OF SANITARY DISPOSAL DESIGN F LOW "' GAL . DAY 13$ ` �� Z L � �'� � � 'r' F' SYSTEM SHALL CONFORM TO MASS . - / LEACH�4 � MiN. INCH C3�p - f. !. -7 E NVI RON ME NTAL CODE TITLE V (REVISED 7- 1 77) `_..__. _ f f -- _ x iS'O�o � � . 2 ' �Q f a,5= zAlt' n/ 57�,�� PROPOSED LEACH CAPACITY . A N D THE TO W N OF _ I f < �-✓ z c 2 ' c > q'LJ 5� � HEALTH REGULATIONS . } ` � • SEPTIC TANK, DISTRIBUTION BOX AND LEACHING PITTO BE OF REINFORCED CONCRETE : MIN CONCRETE STRENGTH 3000 PSI � '3 GAL�fL .hY MIN . STEEL STRENGTH 2O00 PSI � 4 ) 7 " t) H 10 DESIGN LOADING � �� • DRIVEWAYS NOTTO BE LOCATED OVER SYSTEM UNLESS H - ZO DESIGN LOADING IS USED. w� `' • ALL PI PES AN D FITT 1 NGS TO BE WATERTIGHT AND TO BE OF CAST IRON OR SCHED 40 P. V. C. SITE PLAN SHOWING PROPOSED CONSTRUCTION SH. _ OFSHs LEGEND L o CAT i ON �K__�1_ C3 Nip ---------- _ FOR : M ' - Z:) V A P P R O V E D 19 SC ALE : DATE /� � ✓ .% � BOARD OF HEALTH BUILDING SETBACK REGULATIONS PER EXISTING CONTOUR - - -16 -- REFERENCE : BUILDING INSPECTOR OR BUILDING PtA�/ L3 K .; Q i , 12 �,' DATE AGENT -- I6 - 39g PG COMMISSIONER ' =""'n/�- C PROPOSED CONTOUR,77 I 9 99 AJ, IN FRONT SETBACK ;3C EXISTING SPOT ELEVATION 176 MIN. SIDE SETBACK / PROPOSED WATER SERVICE W ��`pOF OF C AIG MIN . REAR SETBACK TEST HOLE LOCATION dSEPH �� �� R R, VIL y No. 13NO SHORT, p �` INC . 7483 EGISTEREO O� .: C . R . S H O R 1 , t 1 �I � CISTER�� gNOSUR��`y PROFESSIONAL LAND SURVEYORS E. ENGINEERS Fss/GNAL �N� Nov. IfIcr, 1586 MAIN STREET (RTE 6A) EAST DENNIS, MASS. 02641 �/� r