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HomeMy WebLinkAbout0200 THORNTON DRIVE - Health 200 Thornton Drive A= 296—024 SEWER II LOCATION SEWAGE PERMIT NO. VILLAGE I N S T lER'S NAME i ADDRESS 8UIL0EIII OR OWN En z .. _ DA T E PERMIT ISSUED F-0 DATE COMPLIANCE ISSUED V oe al-- 7zG I � • rr� rp LOCATION SEWAGI�J VILLAGE INST44LER'S NAME i ADDRESS 3UILDEIII OR OWNER DATE PERMIT I S S U E D DATE COMPLIANCE ISSUED�� ,ZQ -� V oe af- Irv;�Q4,�y � �zG z5 � �g LOCATION SEWAG LE"V--* . VILLAGE A/ Al-NIS INSTALLER'S NAME & ADDRESS rr B UILDE R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 1 Ally fir' r; No............�9..1...... ........`............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ■ ? -----`emu�.-�.,-...-....oF....�.: .-��..�a-..�..r`.---�--�--•---.�------------------------- U 0 AppUration for Ui ipusal Works Tomitrnrtinn amit 4oApplication is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal System at Lo tion-Add ess . Owner ro A •re .. ....... Installer Address Size Lo�_/ S feet d Type of Building ii.. . . q U Dwelling—No. of Bedrooms_ _Y _d'_ ........Expansion Attic ( )' Garbage Grinder—(—") aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ('S Ga Other fixtures --------------- ---------- WDesign Flow...............`...._..._......___....._,..gallons per person per day. Total daily flow....... .................gallons. WSeptic Tank—Liquid capacity.�.0100gallons Length................ Width................ Diameter................ Depth_..._........__. x Disposal Trench—No. .......' Width_.... Total Length___________ _______ Total leaching area q. dd - --- ------s f t. Seepage Pit No._.--___.-_l-____-- Diameter--____��.-_- Depth below inlet.....I,�._........_ Total leaching area_�._�_.�_sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by------Au_j...MVt2AJIsj-•.a..T-k.a/16--� Date.___1/7..�� Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water_. G4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water- 9 ---••••-- . •• --------------•-••••.----�•�......----------•----.........---..........•••••................................. r O -•••••......--.•--- ODescription of Soil---- -?--- _1_. ------lkh.04.Q-t•=-- ----- ----------------------------•--=----------.---•------------•-----------------.............. U . � yy ' = W ------------------------------------------------------------------------------------------ ------------------------ UNature of Repairs or' Alterations—Answer when applicable............................................................................................... Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with F;athe provisions of LITL L 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 by the board of health. Signe -------------------•.....----------------------•---••-••--•---• --••-----•-•.... ........._.._ z D e Application Approved BY f .... 2 3, ..°._... Date Application Disapproved for the following reasons:.............................................................................................................._ -•------- ----- -------•--------------•-------•---------------........... ------•----------------------------------------------------------------------------------------...------ Date PermitNo......................................................... Issued. .................... Date �v FEa rye_ NoO/.fv1...... .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �.w...:<?.......OF.............Kl.�.-Al - ". ..................... Appliratti pat for M-4posaal Works Tomitrurtiutt Vamit Application is hereby made for a Permit to Construct ( ) or, Repair ( ) an Individual Sewage Disposal System a� ..........................`` U 3;4, 1' !t`}t tU�lE. ..........-----------. .............. ---------•------.......................... -- . ............... Location-Add_ress I or Lot No. --•....--••---•--• _...----••----- 0114.4 '/y�j Owner /\/ {��s�� /I ��J Addr WC/`!!' .....X. ............................................. MG_:_JG4�V/••• •.._�]c. h I Ll Installer Address U Type of Building (A. 8 ��fly, �' Size Lot........-...................Sq.feet Dwelling—No. of 'Bedrooms............................................Vxpansion Attic ( ) Garbage Grinder `4 Other—T e of Building ............................ No. of persons............................ Showers — Cafeteria 04 Other fixtures .<11 ........y �•� ..-----------------------•--......---- r Design Flow ?'......................A n)1ngallons per person per day. Total daily flow.___._......._..............................gallons. W WSeptic Tank—Liquid capacity_. %_..__gallons Length................ Width................ Diameter----------------YPqpth7............. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter......._............ Depth below inlet.................... Total leaching area../f.......i.....sq. ft. z Other Distribution box ( ) Dosing tat3lc�(/ ) 1 v,^n y{ , %, P_i li ///7 / CI '-, Percolation Test Results Performed by..--- 3'•--------•-----•-------------•-•••-•---•-•....._....---------• Date...................... --•... Test Pit No. L_______________minutes per inch; Depth of Test Pit.................... Depth to ground water. (i Test Pit No.,2................minutes per inch Depth of Test Pit.................... Depth to ground water.- �¢.L- {h�' rx �t�• � i-•--•-- 3-.i 44.-•v ..-,�1._... ------------------------------------........................................................ ODescription of Soil---- -M-kr-A.......... = ---------•--- ----------•----------------------------------------------------------••----------------------------------- U 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 TITIE- 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 by the board of health. Signed..................^ ------...._..------......---------------------------•-•-••-.•---• ................................ Date A lication Approved B •. . •--...................... -.-------- e PP PP Y----------- -- Application Disapproved for the following reasons:...................... -------------------•------•--•--•-------------•----•-•------------------------ ....--------••----------•-••----••-•------•--•-•------•-----------••........--••-•----------•-----•--••---••••----------•----••------•••-•-------•-••-•-••-•--•------•---•---•---•---••-•-••-------•--- Date PermitNo...................... ... .............. Issued_............................. ........ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH (9rdifiratr of OpaYutpli attrr TILLS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by........... � C-K.r:.._Q-1 1-1--------------------------------------- ----=-----------•......•-------------------------*......------- ........•••.......-----•--------- Installer at...... ..........................................................:--;----------------- has been installed in accordance with the provisions of 'I ITT 5 of'The State Sanitary Code as described in the application for Disposal Works Construction Permit No.. � -•- -._- dated__...___,c,� _ �_;:__ .._...._._. THE ISSUANCE OF THIS CERTIFICATE SHALL OT B9CONSTRUED AS A CrUARANTEE THAT THE ,SYSTEIVI,WILL:FUNCTION SATISF CTORY. 4 : DATE................ Ynspector... a w THE COMMONWEALTH OF MASSACHUSETTS r 7r s t BOARD OF HEALTH ............. ............'OF.....1. )1)... .!'�/\.. FEE 0( �'O Diapo lat lVorkv Tonstr'urtion Vamit Permission is hereby granted........V k e!J.._...A tx.N.----------------------- •--------•------------------------........---•--.......---•--........ to Construct °) or Repair ( ) an Individual Sewage Disposal System r �j` �� r at No....-.. LIA...4_4- --.-_ _:-1101w_- ® ..----------•.n � n / ----•................ Street +x as shown on the application for Disposal Works Construction Permit No..................... Dated---- .. . . 4LRY h DATE................................-............................................. FORM 1285 HOBBS & WARREN, INC.. PUBLISHERS "` ' S//CT o/= Z. Sh/ TS v` AJ-' I fo 10 k S 8 ✓ -' oS9u a \ Xo \ W 0 \ q jj 13 � p A CERTIFIED PLOT PLAN a,lw 0 I-OCATION .QArz•,�srg4c Miss. SCALE . . DATE,�/4 8 /98v PLAN REFERENCE . BE.��G. . .Lo 7-;'/o . . . . . . . . . . . . . . t / I CERTIFY THAT THE WF�O&RMS SHOWN ON THIS PLAN ISEGROUNDAS SHOWN HEREON TO THE SETBACK REOU'It$ THE TOWN OF /�'IA�r95,�/i�/ C'� %� .PEti1Z73/ T7GtiST .. . . . . . . . WHEN CONSTRUCTED. DATE PETITIONER: REGISTERED LAND SURVEYOR 0 T Z Z S/Ae TS .. L. TOP OF FOUNDATION CONCRETE COVER CONCRETE COVERS MMMMM•'� 4' CAST IRON ` PIPE (OR 12°MAX. 12"MAX. T/4 4°ORANGEBURG(OR EQUIV.) EQUIV)- MIN. PIPE- MIN. LEACH ° PITCH 1/4"PER, PITCH 1/4"PER.FT. PIT 0 o INVERT _ aG o EL.!O¢! Q..• INVERT INVERT o . SEPTIC TANK DI ST. ° w .INVERT EL..!4'�•./.L BOXEL!° ,78,EL.!P .?�.. � Q'q. GAL. INVE�RvT INVERT �•' ww � 2EL....-9. . �o 0EL 14,V. w � W D I A. D I A.----►-I PROF1 LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE Nth IELIMI NARY SOI L LOG WITNESSED BY : ram. ? 80 9'3a . . . . /� L ti1u DATE .. . . . .,. . .... TIME. �"1 . . . .��. BOARD OF HEALTH TEST HOLE I TEST HOLE 2 Tr �fs. �.• �f'� ENGINEER ELEV. . 104- LO . ELEV. /O-'-30 T'RPSo iL T�,p 50 zau DESIGN DATA NUMBER OF BEDROOMS �!✓AT '/o�s t TOTAL ESTIMATED FLOW ?S�. . GALLONS/DAY .S xx�c BOTTOM LEACHING AREA 7B�So . SO.FT. /PIT 0 SIDE LEACHING AREA i88 Sd SQ.FT./ PIT GARBAGE DISPOSAL (50% AREA INCREASE) TOTAL LEACHING AREA ZL 7 oc� SQ.FT PERCOLATION RATE MIN/INCH LEACHING AREA PER PERCOLATION RATE SQ.FT. ! . .WATER ENCOUNTERED NUMBER OF LEACHING Prrs 1.P1.7-w177-1. 7Z'!, '€� ' APPROVED . . . . BOARD OF HEALTH I DATE . . . . li AGENT OR INSPECCTOR OF ]--*'l O ''�"si n` +I 't. oTHOh1A gssgc E. �A9ZAS,,D/1`.�'`. �,�'�.�[ � �/ :'�`-ems: J` � �... •-� � No G/ST R PETITIONER NAL DATE f� �' - ❑ URGENT i e >iASOON AS POSSIBLE r c -ac. FILE NO. ✓❑ NO REPLY NEEDED )i C. R1 i r i P. 0. I?0>: 5.34 «YA ai J lit. A TTENTION r0 SUBJECT �FIRNsI�.t�, wale Z;' � MESSAGE �f/� �.l�O t�i�r/� �vs�.w�ss�S �,C-'.cam'" .�ic�•vct7� UrtiOt�' C...�' �/©. 1l'l�ac�/Ji,�/G io S�7�zjl��/ I� ,t�iC.K 6f��fTT /r�I/�5T✓>�: r -> fJTa 5 3 = r#&e AI OAI ��°Ir/k, BUT -Vv. -r AiP. f�L- eo ►✓ A0"/./4 /07- L/7 TQ/� �/�k' ` IAI 6/T/�/k h'®S Uulwi S/G� .� REPLY D O . RE Y SIGNED SENDER: DETACH THIS YELLOW COPY FOR YOUR FILE.,-MAIL WHITE AND PINK COPIES WITH CARBONS ATTACHED. : ;