414 Application & Plans 1984 CHECK OR FILL IN WHERE APPLICABLE
No
Fa ,,,,,, mr,t
THE COMMONWEALTH OF MASSACHUSETTS ,140:-.,;;,,zi D�Afff%,,,•
/J
BOARD OF /HEALTH ;oa % (1 °may:
ei rci. OF t' rPAX /0/On •a a Fd,,W N;
gtpliratir t fur Tfnpu5at le arkn Qlnttnh' wtinit PPrtttt � a.s. 3
Application is hereby made for a Permit to Construct ( ✓r or Repair ( ) an Individual
System at:
74.._°/N Ca/c, Li :dia. 2i'
V .' Lxatio .Address
Owner
21$ CIgte._H etNss o.
sght.destitnixth n 44
Installer Address 21724
Type of Building Size Lot y Sq. feet
Dwelling—No. of Bedrooms I/ Expansion Attic ( ) Garbage Grinder ( ) %7.e
Other—Type of Building No of persons Showers ( ) — Cafeteria ( )
Other fixtures
Design Flow ,575- gallons per person per day. Total daily flow °/leO gallons.
Septic Tank—Liquid capacity/140 gallons Length Width Diameter Depth
Disposal Trench—No. Width.T Total Length Total leaching area_-22.i sq. ft. AO
I. Diameter.L5' ec_]. Depth below inlet 5 t Total leaching area_ ft.
Other Distribution box ( ) Dosing tank ( ) �7
Percolation Test Results Performed by LegeCaen E/OS Date-F.T f-t- 2Q._.(1.ng
Test Pit No. I 6 minutes per inch Depth of Test Pit JO Depth to ground water . ./ctn..e..
Test Pit No. 2 minutes per inch Depth of Test Pit I ' Depth to ground water t10y.e.
Description of Soil 5J.14ROS.fi%
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?1 T LE 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
Date
Date
Application Approved By
Application Disapproved for the following reasons'
Permit No
Issued_
PLAN SNOW i NG
For Mark Reioiak
113 college highway
Southampton , MASS
At: tirn Co/es Meadow
Scale .. i ' 4o'
Sy Frederick Fil ;os
0
M
Rose)
0M
Scrim
'MAK
SEWAGE
Lpa sid�=P <�
tS>>' , .y ,a,VV .ktQ�
�¢ tare., P•
DISPosAL
?une
1984
Loft 2-
23,720 Ft±
175.'
SOLES MEADOW ROAD
PROFILE OF SEPTIC SYSTEM (tine /9st
cor /dark Rejriak Scale; /4 ZonSQJ
213 Co//ye liorAtear Yerf cca/
Southington MA By ; Treater/a fi/os:
. •h: gig Cales ,f/eade& Rd-. •
0'0 ,,r0 b:"0 Qy5° es* 0'0 CO e4 1° e'10
IINI t
100 ,'f, e/a✓.
B.H. na, / in
ts" Oak
,'
_/0 arou„d (.
�
altH OF 4,
l r_e qff,,
f7 -,,,, K�l7ES, R.S.
ms •' �*� Dry 1It I J sea
Wcll �d * * * „
' ' Ce/cN./a ;an s
/f Bdm x lie = 9f96 ya2/ons re9uired
Tt1:' - — — At 6 /fin o4
ank 4'. /5 g x 7 x 2 c&s o .514$ s A/t ia/per .s .Ai
Lc a d, P.1 fa1/owr .7/ - a „ -
Sides iS.jxcs 2 /d5SSg 'Ft
7 x Si ”( 2 n 70
.8of/ary /,sx7' _ 22c x /66 r 373.57/ 1
DEEP 501L. LOGS
OWNER Mart /lein,n
LO CA TIOIJ 91 <'oks fiteadnu Rd %'lharn/ohn
lot 'et
o.
0• - 4"
s
za..-3&.
So"- log'.
Topsoil
SLLbea∎1
Coaroc nand w:W. cobras
sli�y'ti41y c:r.v. 4;U
re C- and Sari dy w*%,
cebbk and 64trne
Craze ad WI none
0
9.. - ty..
Zy"- 108"
Tops0:1
5LLbso:1
tce -Ito"
Cr Mid 14C•/er
'Red:%L -a w:th
c obble
Clean medi-.m Sand
none
Pen-0la%oh gal-,
min/
Dale lord to:/781
oDSERVER F. A. g/,'0
Ground tAh/er
C o ,td (.(. ler
al- y9 "