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HomeMy WebLinkAbout0053 STURGIS LANE - Health ��g ��� L O CAT IO . �1'v.t SEWAGE PERMIT N.O. L-0 r VILLAGE INSTALLER'S NAME i ADDRESS e U I L D E R OR OWNER aAl a 6JiL— Z44 DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED 6fg1IRS e tit n 30 7v r \ f l �I u • h®:,. . 5- ....a..:� . F>�$............................. r THE COMMONWEALTH OF MASSACHUSETTS BOARD �OF HEALTH Appliration for U44pasal Works Tomitrudiurt ramit Application is hereby made for a Permit to Construct ()() or Repair ( ) an Individual Sewage Disposal System at Location-Address or Lot No. ......-•................. -•-••-...................••---••-•--......_....................••.. ............ Owner Address W Installer Address Type of Building Size Lot_56.4_5.ra_9_ Sq. feet Dwelling—No. of Bed rooms...........................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons---_________________________ Showers — Cafeteria •• - --- ------------------------•••••••--•••••-----•-----•---------•----•--••--•-•;�-J®---•-•-••--••-•••-••-•-••-•-•- � Other fixtures .....tiQ�_ ._____ . � Design Flow.... gallons per person $ r day. Total d�}ly flow............................................ to 04 Septic Tank—Liquid capacity!_______...gallons Length___._?-__.... Wldth..A .... Diameter__._ -___•-_- Depth_A _. Disposal Trench—No..................... Widt ._.. . Total Length Total leaching area___.........._......s ft. P. hr - ------ g �--•- - g q• Seepage Pit No... ------ Diameter._A3... : Depth below inlet.... Total leaching area.. Z Other Distribution box ) Dosi tank (_ ) '-' Percolation Test Results Performed by--- :_ `0.._.._.•......................................... Date..�11.t-i. `1"____._.._._.._.. t4 Test Pit No. 1---_._..2'___minutes per inch Depth of Test Pit-----�_�' _ .. Depth to ground water.__��'Y'.�_.__. fs, Test-Pit No. 2................minutes per inch Depth of Test Pit......166..... Depth to ground water____.�''rr-0Q._+e-r r, r - ----„-••.......4 .................;I....................n...----•-- ••-•-- - vr. O Description of So = i ©`! -. oa�:.�'Su�o. l '�2 he_��� `12 ' e�.� v. P �� = r� T + r, o - a - e� 44 Y------ �. 2 �7 �8 0 `S W ]n� .. °1 - 12o vine uv� Sw.�11 ov,es ce t] �c��`\ 1'a o -141 c aae e .--I--•-- _- .---•--------•----------•-•-----•----.....%----------------------------.....-�----------•- ----------•------ �o.►�� 1 U Nature of Repairs or Alterations—Answer when applicable..._________________________________________________________� ............................. F' "'^' ----------------------------•--------------------•-------------- ..............................................................---------------------------------------------------------•----•.....•••• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLI� 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b the boar ll of health. A n-_ Z j ct_®5— J L� f% /�Signed - ------ / 1_.=__.`:._'. • t Appli ton Approved ........... ------------------------ ----•... _ a Date Application Disapproved for the oBowing reasons----------------------------------------------------------------------------------------------------------------- -------------------------------•-•-•-•-•......__....----•-----------------•-------------....------------.----•••--••--•---------•-------•---••-••-•------------••-••-•-•••-----••-----------•••••------- Date PermitNo..=......................................-_----------. Issued-....................................................... ` . Date FEE........:::...:.:.......... +• THE COMMONWEALTH OF MASSACHUSETTS BARD OF HEALTH own Appliratiou for Uiiipaiial Works Tamtrtt.rtion rrmit Application`is hereby made for a Permit to Construct (X.) or Repair ( } an Individual Sewage Disposal System at: , (� ,J �-}yr i S �arl �. 0+ P�':' {"I`_• 2'1 p G`� . ............_ -` -.........----...._....... Location-Address or Lot No. ......................-.......................................................................... •••------___---•-•-•-•----...........-----....._._............-•--......---.......--•----.....•--- Owner Aedress i Installer Address t- U Type of Building Size Lot__ _I_5� `Sq. feet ,., Dwelling—No. of Bedrooms...... ................._..............Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures ._....__._-•-•• •. -- •••••-•--••-••--• ••...._._.---•-•••----••••••-------••--•-••-•--•-•............. Design Flow__________...5 ........................gallons per person r day. Total daily flow.._.__._____ _Q___._______._._._gallons. � Septic Tank—Liquid'capacity.lO��gallons Length.8. _.___ Width:_4,���_.. Diameter________________ Depth___ �_.q:� Dis osal Trench—No .................... Width.__.__ _ ._______ Total Length Total leaching area___________________s ft. P � -- g �---- - g - q• Seepage Pit No----- Diameter-.1�_e _: Depth below inlet____ __e: :Total leaching area__S g`�cs -- G) z Other Distribution box (W Dosinor tank ( ) Percolation Test Results, Performed b k.:.v Date_ .�_l_j_S_�_a___ a y .._..-•-•-•••--- •-•----------••-••• _- 9•___.__-•---•--- Test Pit No. 1._.� Z..minutes per inch Depth of Test Pit-------_�-`�_�_._ Depth to ground water----- ..... t Test Pit.No. 2..............__minutes per inch Depth of Test Pit.......I4i.... Depth to ground water......S!—r_co�v,�er�d ----••-•---------------•----•-----•------••-••-•---•-----•-•-.....--------• ............ -- ............................................... 0 Description of Soil �.: � O-fig' �oo r.,.S SJ�o. 1F 12.. -. eSa�� _vhe. 5�na Sov�.e �44 IW'L�. Cow�Se Sc.nc� �' 1� O S.. pc.w c 'r'e` Sa..,c� 8`- 12p vr-e .JahcA ', —Jr'a-11 S�oY+eS ic-ace !o�.1c�e t 120 -14y-_G� rve 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 TIT LE y g g p y �of the.State Sanitary Code—The undersigned further agrees not to lace the s stem in operation until a Certificate of Compliance has been issued by the board of health. ,.•-- %Signed._._ V'1 Z ��" r •� ,! � : Date• Applic wn Approved �.--..._--•- --• -• -•-- ._.. .:._ $ . Date - Application Disapproved for the following reasons:--•••-•.._...__...-••---••-•-•--••----•••-----•--•••-••-__.__••--•-•----•-•---••-•--•-••-----•-••••--••-•••-•--- Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... Tardifiratr of Tantlifiattrr g THIS IS TO CERTIFY That the In'• idual_Sewage Disposal System constructed ( 4 ) or Repaired ( ) by................................................ r. .•-•----•••-------------------...:.---------------------._._,_:._..--------------------:_..__......;.-- Installer has been installed in accordance with'the provisions of r11 r: j of The State Sanitary Code as described in the - application for Disposal Works Constrdction Permit No.........._.----------------:............ dated------- ....�_. _-....- .p_________________ THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CON TRUED AS A GUARANTEE THAT THE SYSTEM WILL FUt+CTIjDN SATISFACTORY. t DATE: // ...................6?.. 6 d ss �_ ....&5_._.. Inspector .... THE - COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH NO......... ............:: FEE Permission is hereby granted......E-L-w-5 l ...... •.---.('�,Q��lln�d vT11 I 1 E� ;}•............. to Construct ( __'') or Repair ( ) an Individual Sewage Disposal System at No d r Street as shown on the application for Disposal Works Construction Permit No.__; ........__.... Dated...........______________ "_._.__..:+____. 1 ------------• Board',of Health DATE............... ____ _______ __.._____................................. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS l SECTION - SEWAGE - \ I -SEPTIC TANK - "D"BOX - 12 - LEACH PIT TOP OF FDN (MSl)tt "2..OF t/8TO i/x" ^ pl r .r'I J �^ �o :\�fh�A WASHED STONE 1� f -\�e��Y� W i f 4 IN. OUT 10 }1)0C, G IN. OUT IN �S O 1- S SEPTIC TANK SO 1--�--�- a s, ELEV. ELEV. ELEV. ELEV Co �' ( \,P(�.O GS.o • •, �P`� ELEV. ELEV. � - I-=I� -,-->i ;a,I-<-- " -, WASHED STONE— TEST HOLE LOG - d a f:of o No TEST BY � / /f Tom_-,. •,•._` TEST DATE' (��5�84 WITNESS DESIGN 3 BEDROOM HOUSE60 T.H. # 1 T.H. # 2 / ,,•� f T y '`� `l� I - ; ELEV.rI$-Z�ii . ELEV. 'Ill•�ANO tow _ as l 1oa.+. DISPOSER DISPOSER ta'' "I I .•'1 PERC RATE <Z- MIN/IN. FLOW RATE 330 (GAL./DAY) r '1r1. A *13 q SEPTIC TANK 33O x (I�)= 4�t �►2'• (0'7.2� Ila ( .-S REO'D SEPTIC TANK SIZE 10 0 0 a 1 \ \ L O-T ,..? me.cl Me<l �e°.�Q- LEACH FACILITY 54) SGo S.-F M n�1 S !ca eL SIDE WALL l0?1'Co = I$8.� (2.S) = Q t•3 G/D. \ f �� BOTTOM loz 'iY/�(y = -i s's p = S.S G/D. izo.. .. TOTAL ZG70 G/O Ro Q I OfJE 11 PIT USE: LEACHINGy c 144 (05-� t "4C> WATER ENCOUNTERED NOTES: (UNLESS OTHERWISE NOTED) 22 � �t 1. DATUM(MSL)-TAKEN FROM-..__ �............ .......QUADRANGLE MAP 2.MUNICIPAL WATER------_--_-_1S_._.._____._.........AVAILABLE 3.PIPE PITCH:V4"PER FOOT QF (C F 4.DESIGN LOADING FOR ALL PRE-CAST UNITS:AASHO- ,0 -44 q F 5.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT. O� ARNE L� }O--DISTANCE AS CERTIFIED 6.PIPE JOINTS SHALL BE MADE WATER TIGHT Fl. t� SRN H• s 1� -1(0/ � 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. -'� STATE ENVIRONMENTAL CODE TITLE 5 O OJALA` cn : ,ALA SITE PLAN LOCUS: NO sua� REG. EER REF: Lo t- P.F3 Zrio tPC� . Cow down cope' engineering PREPARED FOR: ' t'• " CIVIL ENGINEERS •�, LAND SURVEYORS - ------ BOARD OF HEAi_TH REG.LAND SURVEYOR. CONTOURS (EXISTING)------------ g/��)JSTABLE �� Main$t.,• 2L} Sc, / SPALE ;— (PROPOSED)-O�-O-O- APPROVED DATE - ,MA j Y� � -3i DA E r.