HomeMy WebLinkAbout0006 CRAIG-TIDE WAY - Health '�a—ig--tide Way
Centerville
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Omdord, NO. 1521/3 ORA
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1 THE COMMONWEALTH OF MASSACHUSETTS CTTO
AN" E
BOAR® OF b—iEALT�tt 'A �� _„�, a: <,
OOfd MISSICAN
.n.....................oF....l ari,s l...,
M ApVtiratinn for Uhiplaiia1 Workii Tnnstrnrtinn thrmit
Application is hereby made fora Permit to Construct ( ) or Repair (� ) an Individual Sewage Disposal
System at
---ca-x4riviL.................... .............. .Q ............ ........
Loca iod-Addre r
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�a�►�_. --�a... ..................
. 343••�S�rot,> �o.l_ ,..C��n c,cl�
Owner Address 'n
---- ncla-------------------------------------------------------------- --368.. !'�.S��sQa�t... g �.. 1+IQ4�C,..
cc
M Installer Address
Q7i Type of Building Size Lot...........................Sq. feet
U DwellingNo. of Bedrooms.............3_ _.__.Ex Expansion Attic
— ---------•----------- p ( ) Garbage Grinder ( )
Other a —T e of Building g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
Other fixtures .
W Design Flow............................................gallons per person per day. Total daily flow--_--_--_—?34.....................gallons.
WSeptic Tank—Liquid capacity.10*0...gallons Length................ Width................ Diameter._.__-__--...._- Depth................
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--------------------sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box (P-� Dosing tank ( )
W Percolation Test Results Performed by...TwA----Fay.,4!- . 1................................. Date----1b AY'81...........__.
Test Pit No. 1-_--2.�D...minutes per inch Depth of Test..-�r
�. •• p p A14P...__ Depth to ground water-----. iao.........
f1 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a+' r �.,7 .......................
O Description of Soil....5.��{- 4tri�_. .Q .5.:�.it��1....C1LR�lUJ►�1 = - -- - - - .. - -
x
c.�
W
U Nature of Repair$ or Alterations—Answer when_ applicable.....1QOc?_.c�G�._�'Q�f4G_�l _.. _.+.-: ------ Q ...4qf..........
gLg�
Agreement: D
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.
Signed-- •D .......................................... .../-Al E A(o........--
Application Approved By........... . .•..... . ................................. ......... Zl.N6........
Date
Application Disapproved for the f lowing reasons:................................................................................................................
.--------•-•-------------•-----------.....-----• ------••--•-----------------•-----•--•---•.._..-
Date
PermitNo......................................................... Issued.......................................................
Date
No......................... FEB 3.:..� ..
4
THE COMMONWEALTH OF MASSACHUSETTS.
BOARD
,� OF 4 `HEALTH
pwyl 1�Cerns
...---.....OF........................................
Appliration for Uhip aal Works Towitrn.rtiun Errant
Application is hereby made for a Permit to Construct ( ) or Repair (-)�) an Individual Sewage Disposal
System at: I
..... -•,> y ay ...%..ta........ � �
----......----................. ........._.....-• •--_. __�r•-------o.rr I.z/_r.�.._..c.o.�..
c.J..,..-C-•-�c .._... ........•-•--
Addre�LQA X o 3y3an- t ,
� .._....�.. ....5� nUn .-• q• _
Owner Address
S-a u n�4f .................
.............. .-•-----•--•-- --------
.--•------------------••••---•• •-----.._..-• ••..s ...��C
Installer AddressPQ
U Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms.............- _..........................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons............................ Showers — Cafeteria
pa Other fixtures ---------------------------•---• .. .._
W Design Flow............................................gallons per person per day. Total daily flow------------
�30----___________.____.gallons.
WSeptic Tank—Liquid capacity lgo�-..gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No. .................... Width.................... Total Length.....................Total leaching area....................sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( k�- Dosing tank ( )
~' Percolation Test Results Performed by.__..t.Z.m.._F(3Y?. ! Date__...�:d :__`�S
►a O 5j
a Test Pit No. l..... :...__._minutes per inch Depth of Test Pit.__ . ____ Depth to ground water.._.�'ZC3
----------
G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
O Description of Soil--- C�2cA ...n'_t ec�lU m 5q - - - - - - - ...._... --
x
U -------------•--------------------------•-•----.........------..---._..._.....--------------------------...---------------------------------------------------------------------------------------••••--
x ••••••---•--------------••--------------•••••-•-•••••-•••-••---•---•••-••••••--•••••-•--•••••••••••----••-•••-•------------------- ��. ----
Nature of Repairs or Alterations—Answer when applicable_____1.6Qo_9 �� �G I ���.� w
�ectc. ....._--_�15 n as t� ulrQci..
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITIL- 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been isued by the board of health.
Signed-----�:_ y �Co�+<
-._....r.... f
p.... a
Application Approved BY - '�.:_... ` fi
..............••-•-....••••• -
.. (-.- -••--•••-
Date
Application Disapproved for the flowing reasons_..............................................._.................................................................
..........-.........................................-....................................................................................................................................................
Date
PermitNo......................................................... Issued------••-•----------------------••---•-••-••-••---•----
Date
upon N2 U�'Yo�� �- THE COMMONWEALTH OF MASSACHUSETTS
t" BOAR"'DD OF �H� fEALTH
............ 1 r,w'n..............OF......15LO7S�tcabI2
fTrrtif iratr of Tomplianrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (i4,)
bY------------------ ......................................................-----------------•--•-----.............--------------.._.._.......-------............_....------....._
Installer
has been installed in accordance with the provisions of TITIF j of The State Sanitary C# as described in the
(/
application for Disposal Works Construction Permit No.__..�5�.��:�..:__._.._. dated_..1_ _''�-s___�'_____________________
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WI"NCTI N SATISFACTORY.
((
DATE--•------•-•----....-•-•-�=- ...................................... Inspector.................................................................................... ...,
.1 r
(,(h-1•o f GQ Baron t# 2 THE COMMONWEALTH OF MASSACHUSETTS
YY BOARD OF HEALTH Lr
V J -f ..
..................OF.............:r'l. W'`J Ie
No......................... ',Y . FEE...............
Permission is hereby granted......_... ........................................
to Construct ) or Repai?K( ) an Individual Sewage Disposal System
atNo.-•--••-••-•-.T..?...........(.14A'(-----11Q.k----'�.A4......... ---------------------------------------------------------------------------------.....
Street
as shown on the application for Disposal Works Construction Permit I&_-S',4-:_______ D ted_.___t :5 1 C.................
................................ ----=..............................................
Board of Health
DATE y- --•------------------ --------- ;
FORM 1255 A. M. SULKIN, INC., BOSTON '
L C Yl A G E P Z R M I T f0.
5 T A L L E R'S H A V1 E AD R C 5 S
13 C,6^ c 0
R U I L D E Pk OR OWNER
PATE P ERMIT ISSU E D
.9 AT E C 0 M P L I A N C E ISSUED'
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THOMAS E.
FANTOZZI
No. 831
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