HomeMy WebLinkAbout0180 CONCORD LANE �37
LOCATION , SEWAGE PERMIT NO.
/ffo �a N co ao Gbh
VILLAGE
INST -A LL `El�R'S NAME i ADDRESS
`R UILDE R OR OWNER
a
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
Nof 43 o� 14- �. Fina.....,��. ..........
a �+
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
q:..............O F.....�� &DVS.T P.64A------------------._._.................
Appliration for Disposal Works Tonstrnrtiun Prrmit
Application is hereby made for-a Permit to Construct (,() or Repair ( ) an Individual Sewage Disposal
System at:
.........................._.-..........�------------....---•------------._.._............ C®NCv-.'-Q-----�_.�..v�............•...............---------......
Location- ddress " or t No
r
o � 9.4...--pal -._Jr/�? ?........:.......... P6-_ ®X_1. .rs.... ENIf ®�� _.0_��3�
--------------
• Owner ��,, Address
Installer. Address
d Type of Building Size Lot._6,.G l 8.....Sq. feet
Dwelling—No. of Bedrooms:_...___.`�..............................Expansion Attic ( ) Garbage Grinder knO
'4 Other—Type of Building ------ No. of persons............................ Showers — Cafeteria
a' Other fixtures ..................................
W Design Flow....................................gallons per person per day. Total daily flow.................... . _ ...........gallons.
WSeptic Tank—Liquid capacityloV®.gallons, Length_a.::L".. Width.4''Pd". Diameter................ Depth. .` a
x Disposal Trench—No..................... Width..._..............._ Total Length.................... Total leaching area..._..._.....sq. ft.
Seepage Pit No........�.......... Diameter.... .... �..... Depth below inlet...4.............. Total leaching area-----.®.........sq. ft.
Z Other Distribution box (-/,) Dosing tank ( )
Percolation Test Results Performed by.... _WAVU.9.11..................................... Date..: _ 84'_......_.....
aTest Pit No. 14EU Zminutes per inch Depth of Test ..... Depth to ground water../Vo---A�
�X4 Test Pit No. 2"W..�_.minutes per inch Depth of Test Pit..l.004.!..... Depth to ground water--J!.o...au,ff9.�
xDescription of Soil......Ck-EP .....eN ..T®---M..,6P W A-,?9t9V'E,e,
---------------------------------
....................................................----------------------------- ----------------------------------------------------..............................................................
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,LL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in------
operation until a Certificate of Compliance has been is ed by the board of health.
gned -- --- ..... ---------------------------- -- ....... . ..... .
ApplicationApproved By----- ----- ..............................--•• --- ...--•-_-. --- ---------------------- •7....�?...
ate
Application Disapprove r t e following reasons:
4
3- Date
PermitNo......................................... Issued.......................................................
Date
N01..................r. FEs......v.....................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
ld.J�(...............OF.....R�- ,'# a?: / J:. .......................................
Applirtt#iou for Di-sposal Works Tomitrurtiun ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
Location•Address or t No
(r f E,( '• ll+ 4 "� �4: ` f ' m `� -------
Owner Address
W "=--- -----........................^•.........-----.....-•- ------••-•---•----•-------•-------•-••---•------_-_-_--_-__-------•--__--_________-__------•--___-
Installer Address
d Type of Building Size Lot--- .....Sq. feet
Dwelling—No. of Bedrooms.•...._._.z..............................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
a' Other fixtures ....:..................................................................................................................................................
W
Design Flow......................._*..............gallons per person per day. Total daily flow..................._ IN. .............gallons.
WSeptic Tank—Liquid capacity €�R _gallons Length. �" p 4Vidth.`.�_���_. Diameter________________ Depth .....
x Disposal Trench—No...:................. Width.................... Total Length.........._......... Total leaching area....................sq. ft.
)----------- Diameter_ Depth below inlet... Total leaching area.:•-..•--•--......sq. ft.
Seepage Pit No..______ � �
Z Other Distribution box ( ' ) Dosing tank
Percolation Test Results Performed by..__. "_ .° .............. - `. !'_.
a •----------------------- Date------- i� . _...------
,a Test Pit No. 1/,_F__I�_Lminutes per inch Depth of Test Pit... _`?.n`: Depth to ground water_.Lva..9mT'�'T
fi Test Pit No. 2Zi_C {_.-..minutes per inch Depth of Test Pit . ... Depth to ground water'1-j... j �{
x
O Description of Soil--•-..`� ....AI&(..---`�.`v'= ° �Y. t`_t� ._ 3il^ ? 3 C P ............................
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 TITLE 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.
ned-----------•-------------------------------------------•----------•---••------------- --------
Application ..........
-�"'' a_te
Approved B _ / �Z '
PP y r- - - Date
Application Disapproved r t •following reasons:••-----•---------•--•--••----------•---••••--•-•-•••••----•--•---•------•-•---.................................
..........................................................-•--•-_.....--------
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF..............................................................I......................
C�rrfifirtt#r of f�um��itt�trr
THIS IS TO CERTIFY, That the Individual Sewage Disp s S_ tem constructed Or Repaired ( )
by..
.<,.. .......................... ;,... , .
Installer
..............1........_..::.__.:_ f Lr .____,z�c ___.___.___.__._._____....__.____._
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Cod`asdescribed in the
application for Disposal Works Construction Permit No.__ `_`j._.�.:,;-17..._......_ ______________________
THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.......................................... `�------__..�-�-___----•--- Inspector........_... --•--•--•..................-•-•---
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
r� /_
Y, OF..................................................................................... .- .
No:...`.............. .... FEE..1_�'
�i��rusttl urk� �ua���ri.al>/n �er>iti�
Permissionis hereby granted.................................................... ,1�, .....•-•-•-•---•-•••-•-•••---••-•......._-•••..............•--•-_....
to Construct"f— 'If or Repair K)an Indi al Sewage Disposal System
` '= ' ��
at {
Street
as shown on the application for Disposal Works Construction Permit No_____________ Dated..........................................
!;f�,,
Board of Health
DATE................ ?_ ..?.1-'-- - .................................. -
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
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jµ OF Mks' N OFM4s
LEY y`
Y OND rn
c y SWEETSER
p 67Z¢ O ,o 'A No.
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/STEpQ' 9p�FG/ST �\�� ae
SUR`tF'y FSS/ONA%_ -
GRADE OFFICE FILE: OKET CH PLAN OF
EXISTING PLAN REF: L,A V //V�3,s,�s-7-WgLAr---
FOR- �CZMS 1 o 14 E-frem .
EXISTING 44R x ! i MALe's$ FOJ4
BY �Ax-TGK, � 1..IYC--- I-1�i1`�,�5 t�`E �� . 1�, • �G14.2'—T7
PROPOSED--.—.[:] DATE Z'Z77-7g
Low' 8 F®.
ELEVATIONS SHOWN ARE IN FEET ABOVE S.R.8WEETSER.ENGINEER
_,d.SSy�(�fl �,c'Tvl''t • 87 SEA STREET.DENNISPORT.MA
DATE 7_9-84 PLAPI ISO E'
--- REV. - ! =.30
QATE A3ENT.B4e-►s'rA�� BOARD OF HEALTH REV. sHEETJ—OR
jGE3/PES '82
EI-EWTIONa DESIGN CALCULATIONS
P1lOP4odcD TOP or FOUNDATION, FOR A - BEDROOM HOUSE (�I/ �� GARBAGE DISPOSAL.
INVERT GRADE NOTES ELEVATIONS SHOWN SEPTIC TANK. j�� X
POUMUIT1ON. CXIT �l,sp S3 ARE IN FEET ABOVE A-" USE A �000 GALLON TANK
SCPT1C TANK IN �!- 17 3. t�Ssurc�� U�T��I , LEACHING PIT:# AREA FLOW _
OCPTIC TANK OUT ACCESS COVER FOR SEPTIC SIDEWALL■ HEIGHl X 2XX XRADIUS CLi�AC
L0o �3- a TANK SHALL NOTBE LESSOAT. lbox IN �o•z'�7 THAN 12 BELOW GRADEx2X�X � V� X
�T SOX OUT `� o-7O S Z-• GTt G c^ � �77HING PIT
s�.�0 _.� OQD✓S� `� 3G 1� ���� ? �� T GP I/ STONE
PtT T SIN BOTTOM ?t (RADIUg)�
1.
PITCH
mod 0 TOTAL , ��7 GPO
1/4" PER FT 12 MIN. GROUND DESIGN FLOW ■ 3O GO
t)(Mr� o u r��-�r o.._,i •• P COVER -7
<2% GRADE. (M qOPE' RESERVE ■ _7 CK'O
D18T. SOx \ ACIIVO TIT 801E TEST CrA
11
r ✓9/ Hwy+r r ;rnagr a[<<I;u rcrAlm sit r!9u1Ir'U[m rrfls I
�J -- i OF r/a%vz'WASHED STONE
--
rOUrD t. (L '2
/l /
j w1M /
U D GALLON
I
6EPTIC TANK ' `PITCH
1/8" PER FT 47.7 3�
1 J
SCHEDULE 40 PVC ea:
OR EQUIVALENT
NO SCALE
� o
Ir
off OF M�S� C WM SNED STONE
v SWEETSER
' i
Mo 12492 Q
.e
9
si37-7
0. `.
�0 WATER ENCOU"TERED 0 WATER ENCOUNTERS- )
TE87 MADE C,-lB-9,L4 - TE6T MADE. "'2-
W/ ?� ���Go� w/ �aIt=�acz3� _
A�.JSTABL>✓ t�33Z PERc. RArESLEE6 TN.AN , Z _MIN PER INCH DROP