HomeMy WebLinkAboutJewell St. #100 - 4/21/1991TOWN OF MANSFIELD, MASSACHUSETTS
50 West Street, Mansfield, MA 02048
APPLICATION FOR ON -SITE SEWAGE TESTING
PERC NO.
DATE
PERC
FEE $75.00
SUBDIVISION ar(l? •�G �� ,7��,t—r � LOT NO..�� �l
OWNER ���� ( �Itl/mil` TELEPHONE,,
ADDRESS ��,� �� i `tom r<j i' I � �,� � CITY STATE-1��—
APPLICANT �,�� �� TELEPHONE
�r
ADDRESS
CITY STATE
ENGINEER
TELEPHONE
c
ADDRESS
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r
CITY cV J (G
STATE
1. In order for the Board of Health to take action on the application, you
must get numbered address from the Assessors Office at the Town Hall. No
application will be accepted without this information.
2. Fee is $.75.00 per lot. Application and fee must be filed ten (10) days
before testing date.
3. Percolation testing and groundwater testing may be done all year.
4. You must know before the Town's Agent comes out to your lot where the
on -site sewage test is to be done.
5. Requirements needed at time of testing:
a. Your own engineer.
b. Backhoe or similar equipment to dig 10-12 feet.
c. Enough water for on -site sewage testing.
d. Sufficient 4" pipe for a monitor well.
6. Permit will become invalid if percolation test is not performed within one (1)
calendar year, provided that testing has not been suspended by the Board of Health.
Fee is non-refundable.
7. All septic system plans and DWCP applications must show soil testing number,
address and lot number.
Original to Board of Health, 1 copy for Treasurer's Office and Applicant
Revised October 1989
Revised March 1991
TOI,N
OF MANSFIELD
PERCOLATION TEST REPORT
BOARD OF HEALTH
PERC
NO.' '
STREET 16b l%--,\(, OivNER/BUILDER �j
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TOWN OF MANSFIELD, MASSACHUSETTS
50 West Street, Mansfield, MA 02048
APPLICATION FOR ON —SITE SEWAGE TESTING
PERC NO. � � � FEE_$75.00
DATE L
5
PERC ADDRESS
SUBDIVISION � �j t Y �; f r LOT NO.
OWNER �, jd� f fly alfy TELEPHONE 5?
ADDRESS �'�7�� �� CITSTATE
APPLICANT ��.,} w 4_� TELEPHONE
ADDRESS �` v ' STATE
l � vt� l CITY:�_J (,-
r
ENGINEER TELEPHONE
ADDRESS) CITY—STATE
1. In order for the Board of Health to take action on the application, you
must get numbered address from the Assessors Office at the Town Hall. No
application will be accepted without this information.
2. Fee is $.75.00 per lot. Application and fee must be filed ten (10) days
before testing date.
3. Percolation testing and groundwater testing may be done all year.
4. You must know before the Town's Agent comes out to your lot where the
on -site sewage test is to be done.
5. Requirements needed at time of testing:
a. Your own engineer.
b. Backhoe or similar equipment to dig 10-12 feet.
C. Enough water for on -site sewage testing.
d. Sufficient 4" pipe for a monitor well.
6. Permit will become invalid if percolation test is not performed within one (1)
calendar year, provided that testing has not been suspended by the Board of Health.
Fee is non-refundable.
7. All septic system plans and DWCP applications must show soil testing number,
address and lot number.
Original to Board of Health, 1 copy for Treasurer's Office and Applicant
Revised October 1989
Revised March 1991
2q,0jqN, of MA.NSFIELD PERCOLATION TEST REPORT BOARD OF HEALTH
L
PERC NO. STREET ob I,— OWNER/BUILDER
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March 106, 19089
Mr. Leonard Flynn
102 Jewell Street
Mansfield, MA 02048
Dear Mr. Flynn.
Attached is a copy of the so."Ll. logs you requested.
If I can be of further assistance, please call.
Sincerely yours,
DUNN ENGINEERING CO., INC.
dv I ]D;�
Wendy Diotalevi
Registered Sanitarian
WD/kf
Attacl-Iment
124 WASHINGTON STREET - FOXBOROUGH, MA 02035 ® (617) 543-9720
00"A engineering co., inc.
Test Hole 41
SOIL REPOR-1
Type
0 11 --0 1� 11
Topsoil: subsoil
a11-9111 Me-11urn y jravc w th IUD
cobbles
mat t 11 � at t 6 0
Grou-ndWater cony
'rest Hole #d-
0 " - 24 " Topsoil & sumsuil
24 " -` 2 0 clear, gravel with
cobbles
Grou-ndwater at 96"
Test Hole #3
ywJ Topsoi: & subsoil
Grey silty gravej.
Groundwater at 108"
Pe�ula,tiun Rate
I
2 minutes per J_TAC-11
I
2 ycilnute.s par inch
2 minutes per incil
124 WASHIND ON STREET - FOXBOROUGH, MA 02035 - (617) 543--9720
TOWN OF MANSFIELD PERCOLATION TEST REPORT BOARD OF HEALTH
MAP LOT STREET hY ASd4 _`C-i OWNER/BUILDER
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