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HomeMy WebLinkAbout0153 SCUDDER'S LANE - Health (2) iS3 ����� � �� �►�s-�-��le _- _ _ _ _ __ . _ a� J��� 1 _ . _ � � J - 1�_ _._ ____._.___ _ ._ ---- »� _-�_. �_ �. 00( 0...... -.: ..,�..�: F�s.....r.. .............. THE COMMONWEALTH OF MASSACHUSETTS BOARD Of HE T 1 ` 060 ....OF.......... . ...:...... ..... ----- ......... Appliration for EUVaiial 10orkii Tnnti rnr#ann Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at AC ev, jon ...........4,� .- ®++ (($$avva��,pp�� or Lot No. ....�+_1�... ... .... c' o .. .e. ............... ...:.e._.... ..... ....._................._...... _ Own , Address W - - --•--- r F Installer ( Address ' UType of Building Size Lot..........................S q. feet Dwelling—No. of Bedroo --______--•_-•Expansion Attic ( ) Garbage Grinder NO aOther—Type of Buildin . --•_ ___ No. of persons.............:.............. Showers ( ) — Cafeteria ( ) dOther fLxtjLres .......................... ----•-------•-•-...•-----••----•-------------•--------------•------ ............................ Design Flow-x-_...__.... _._._._ _.�gallons per person per day. Total daily flow........ ......................gallons. W '-!- WSeptic Tank�Liquid capacitjQ_..---gallons Length................ Width................ Diameter---------------- Depth__•-............. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing ank aPercolation Test Results Performed by... ---------------------------------------- Date...... ` 74 _ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-___---..----------.__-. f-14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Ri ' .••..... L�/ r---/• 7 -•-1------7 �p Description of Soii �.f _I__ .� Y 7 i .7. G. c.> = - 1 -•---•-•------•--- �P cry . x Repair ----- ------------------------------------------------------------ U Nature of or Alterations—Answer when applicable............................................................................................... ---------------------------------------•--------------- ..................................... .....------•-•--•--•----------•-----=--------•--•-----------------------•--------------•--••-••-••.-•---- Agreement: q; The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitar Code—The undersig further agrees not t lac the system in operation until a Certificate of Compliance has ee sued the b a o eal [� ned-....--- •-- . _ • ......:... .........----• ..._..... ... Date Application Approved By......- f ` ......•------- --•----- - Date Application Disapproved for the following reasons:-----••------------------------•------------------------------•-•---------------------------••-•-•-••...--•----- ..-------•..............••-••---•••••-•--•--••-:•--••-•----•---------•--••-•-•-•---••---•••••----•-•-•---•--•-•-••-•--- •-••---•-------------•-•------------•---•--•---•-•--••-----•------------•----- / Date PermitNo......................................................... Issued_ F - Date Ol No. -. '---------.. � y rF�s.....h!.� ........_ ' THE COMMONWEALTH OF MASSACHUSETTS' ` BOARD O HE T ........... : ........OF.......... -- �. , rrlrilan fnxiina1 3 ,ark Crriun Fermi Application is hereby made foi a Permit,.to Construct ( '')<or• Repair ( )tan ,Individual Sewage. Disposal -, ti Syst .� :x. irR .............................. .................................................... .......................................... ....._ c s n. oor Lot No. ... _....... -•• ............................................... W ..a r « Ad dress ....... r-- .. ......... ............•--...._..._........._._........ ........ Address nstaller Typle of Building a4 Size Lot---------------------------Sq., feet *aDwell>ng—No. of Bedroo __________________Expansion Attic ( ) Garbage Grinder wo a Other, Type of, Building No. of persons_.................. _______________________ Showers ( ) Cafeteria Q Other s -------- •-------- Wr Design Flow, _..._:.._.� ___: _ gallons per person per day. Total daily flow---- --- - 0_--.--.--..."....gallons. WSeptic Tanl Liquid capacif 7zh gallons Length................ Width................ Diameter............ Depth................ x Disposal Trench No............... Width _____ Total Length____________________ 'dotal leaching area;..................sq. ft. Seepage ¢", p inlet_..__,_ _.___. Total leaching are a__________________sq. ft. z Other Distribution box (l ) Diameter g Depth �� � F Dosin nk a Percolation Test Results Performed by. 4___ Date___ "_/ _......... ,_.__.. 'Test Pit No. 1_____________---minutes per inch Dep'tll of Test Pit.................... Depth to ground water........................ �74 Test Pit No. 2................minutes per inch ,Depth of Test Pit.................... Depth;.to ground water........................ : t # i 0 Descrpion of Soil' _�. _ .. ��_ "' "_ " .. ._ 7_..:. rh + Wa,► ; _ -- U Nature of Repaiin Alterations—Answer when applicable _____________________________________________ _______" __________ .__.____ ' Agreement ...... -- r -•- - 4' t `�''--- ---- -- � ------ ....... The I undersigned agreest to .install the aforedescribed Individual',Sewage Disposal System in accordance with the provisibus of T I 7yfia - 5'of the State Sanita ode=The undersig further agrees not`it lac ,the system in operation until a Certificate of Compliance'Ilas ee u, d e b o e 1 f 01 : ned ------ -- -_.. ....... ate Application Approved By....... tT` t Date � 9 Application Disapproved for the following reasons:- ...... . ,____;> ________ _______________________ ------------------------------------------------------------........................................................................................................................................... Date PermitNo---`- •------- ------ __:.._..----•--- Issued_................................. ...................... Date ,bl' ., f THE COMMONWEALTH OF MASSACHUSETTS * BOARD OF HEALTH t �rrtgfirttte of Tamp tan r THIS IS TO CERT Y I idual Sew. o st, ( R ( ) ---•- war �"'- ,. e%'� I by..- nst.� has been installed in acc�brdance with the provisions of T r of he State` Sanitary Code as.described 'in"the application for Disposal Works Construction Permit No._:_________ y_____________ da.te-1..._�''4_I'_.. - ,_ THE ISSUANCE OF THIS CERTIFICATE SHIALL-,NOT BE CONSTRUED AS A GUARANTEE THAT THE, SYSTEM WILL FUNCTION SATISFACTORY . " � ? ��DATE.... .... p - 64)1 THE j COMMONWEALTH OF MASSACHUSETTS 3„ f8 BOARD° F HEALT 9 �y .0 No :. s FEE is a .. h��trrtt1` r n trud Ott ' Permission by granted --- - .. . to Cons�t ct ( o a»r"(�- "t ` Individua S���'°°1�rage 'Nos *x y .,w. rf� ................. as shown on the{appl�atio i for DisposalzWorks Construction Per irii`t` �'"... Dat -..�" ' 1................. �. f .Board of..Health,,, DAT _ .� r r s s FORM. p11255�I•IOBBS & WARREN;'INC.. PUBLISHERS ; , " B,q,E'NST9BGE ,a o o� � Cot , � y0P GoGuS U� � POiI/O °° vo O � \ F CZ-0 7' L.c.P. 00950E x -i I $ �O C C� L.C.P. zo yso J �� PeoPos�o [ / TEs r 3 BE02ooN/ OwE4L1A16 Fiesr FG000e � E/2VE ( / M, EL.53.0' edOE S/Gil/ OA 3 x /oo f.9L5. _ 300 \ yV/TH 6.qeBAGE O�SPoSAZr.� 6O - USA 150 0 \ / 300�G.P. U� x /.75 SQ. FT.1GAL 1 W \ G E AG H!n/G oAy = 52s sQ.Fr. �s 6�>l-l�• \ � A.eEA ,eaou/�e&D) \ USE (2) 6'" GEAGH P/T,5 \ ( EFFEGT/VE 4-EAGH/,k1G l � so 5,5 GA//9 6 G I9 yO U 7- A�::11'9 7-i9 TES T" H 0 6 6- e U 7- - - /S00 • ti ir7/et e/e✓ = 4`P•30 A. oJALA P. MuRRAY i out/et eIe% = 49. 04 #/ O - /2" = TOPso/Z-. oliSflibUfi0r7 boX /0"-,e4" "Ce-AY /-!A[eoEAJIIV6" 77Le- 24""- irn/et e/e✓. = 48.50 SoM� F/ivE 5 out/et e/e% = 4B. 33 — (2 ) G,'(deptAJ precast leach #/A pets /[nedtl-� �' �/77in.� of /2"-4B" = TILL GvezS6+ed Sf"or7e 48"-84" GGf1Y Hf!/2DP/�N i r7/e f e/e v = 4 7 9 4771 84"- /08" = Fi�v 6 SAND s/L T Q/. 7/ /08""- /44"` = /-'IElO. SANG TieAcE OF coA)eSE G/eA✓E z- f E,ec. I2fI7-c = 20 M/A/, PE2 /A/CH NOTE: a // /oca.tiornS ShorN/-7 litre ProPOSed or-3/y /V/H.t/HOL 6-S 514OUI-o BE e)eoU6H7- 's \� To Gc)%TH/N /2" OF F/N/S/-/ Y4"177ir7. pitch per foot pea•sforre �SDa / �� a/iSfributior� bOX r preGQ j G p f i G flit r7 / 4 ed/ NOTE T�c a V ' - o .<O v A G (�7 '6/r7. ° ° +T Sfor7e CT e rESEE v` f�PcA / Tom- f •9/t / o F G .�/vo /A/ A for : ©,E' MSS /l/E /L C. .E //L/6L E,E� scale : / „ 40` mate: c./U"& /o, /977 approved: bei/-/c� : LOT -�-- L . C.. PLAN/ 3�870 B�I,E'/t/STH�LE gof�,e0 OF HEALTl�,1 d�.fe I �o rcJr� G a p es E r/9i w e e/-/•�1 - ,.� JaraEB . G'/✓/Lr E/l/G//l/EE�S � ' �� � A/v© Sv�e vE Yo�e s •' ,E'O C/TE- 6 A�YAIE'MO U T/-/ � /SAS i• dGt f'e., ' oes/C,IV BY A.NO 76- 054 o[e�gw/v BY 1vE5